FRED MEYER PHARMACY
NPI 1376588442
Pharmacy - Community/Retail Pharmacy in Boise, ID

Q: What is Fred Meyer Stores Inc's NPI number?

The NPI number for Fred Meyer Stores Inc is 1376588442. It was assigned to this organization in the NPPES registry on June 20, 2006. The provider is doing business as Fred Meyer Pharmacy.

Q: What is Fred Meyer Stores Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since June 20, 2006CLIA 13D0997242 · Waiver

5230 W FRANKLIN RD, BOISE, ID 83705(208) 429-6433(208) 429-6427 Get Directions Write a Review

NPPES record last updated: August 12, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 12, 2016, Jun 29, 2016, May 16, 2016 (3 updates tracked since 2016).

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About Fred Meyer Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FRED MEYER PHARMACY (NPI 1376588442) is a healthcare organization registered as a community/retail pharmacy in Boise, Idaho and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through March 10, 2028 and lists Allison Muennich, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1376588442

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameFRED MEYER STORES INC

Location Address5230 W FRANKLIN RDBoise, ID 83705-1109

Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092

Phone(208) 429-6433

Fax(208) 429-6427

Organization SubpartNo

Authorized OfficialAllison MuennichManager Of Pharmacy Licensing · (513) 762-1019

Enumeration DateJune 20, 2006

Last NPPES UpdateAugust 12, 20163 updates tracked since enumeration

✔ NPI 1376588442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in ID · 1634RP

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacyTaxonomy 333600000X

5230 W FRANKLIN RD, Boise, ID 83705

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Other Names 1

Doing Business AsFred Meyer Pharmacy

Other Identifiers 6

Other2021758Pk

Medicaid806185900ID

Medicaid806188600ID

Medicare NSC0509530091

Medicare PINP01392988

Medicare PIN19108351

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D0997242

Fred Meyer Pharmacy #662 · Boise, ID

Active · expires Mar 10, 2028

CLIA Number13D0997242

Laboratory TypePharmacy

Certificate Effective DateMarch 11, 2026

Certificate Expiration DateMarch 10, 2028

Laboratory DirectorAndrei Rudyi

Laboratory Phone(208) 429-6433

Laboratory LocationFred Meyer Pharmacy #6625230 W Franklin Rd, Boise, ID 83705

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

101 services100 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

98 services97 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

18 services18 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

18 services18 patients

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY GOBEILLE PHARMD

Pharmacist