FRED MEYER PHARMACY
NPI 1891030300
Clinic/Center - Community Health in Tacoma, WA

Q: What is Fred Meyer Pharmacy's NPI number?

The NPI number for Fred Meyer Pharmacy is 1891030300. It was assigned to this organization in the NPPES registry on December 10, 2012.

Q: What is Fred Meyer Pharmacy's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Active since December 10, 2012CLIA 50D0964315 · Waiver

4505 SOUTH 19TH, TACOMA, WA 98405(253) 752-9110(253) 756-9320 Get Directions Write a Review

NPPES record last updated: December 10, 2012. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Fred Meyer Pharmacy NPPES

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

FRED MEYER PHARMACY (NPI 1891030300) is a healthcare organization registered as a community health in Tacoma, Washington and active in the NPI registry since December 2012. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Amro Abu Hallawah, Pharmacy Manager, as its authorized official.

NPPES Registry Identity

NPI1891030300

Entity TypeOrganization

Primary Taxonomy261QC1500X

Legal Business NameFRED MEYER PHARMACY

Location Address4505 SOUTH 19THTacoma, WA 98405

Mailing Address4505 South 19thTacoma, WA 98405 · (253) 752-9110 · Fax (253) 756-9320

Phone(253) 752-9110

Fax(253) 756-9320

Organization SubpartNo

Authorized OfficialAmro Abu HallawahPharmacy Manager · (253) 752-9110

Enumeration DateDecember 10, 2012

✔ NPI 1891030300 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities

Taxonomy Code261QC1500X

License✔ Licensed in WA · PH00009951

4505 SOUTH 19TH, Tacoma, WA 98405

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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 50D0964315

Fred Meyer Pharmacy #390 · Tacoma, WA

Active · expires Apr 4, 2028

CLIA Number50D0964315

Laboratory TypePharmacy

Certificate Effective DateAugust 23, 1999

Certificate Expiration DateApril 4, 2028

Laboratory DirectorKevin Warren

Laboratory Phone(253) 752-9110

Laboratory LocationFred Meyer Pharmacy #3904505 S 19th St, Tacoma, WA 98405

CLIA data matches this NPI record on: Address Name Phone

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

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Fred Meyer Pharmacy #390 carries, from the Medicare DMEPOS supplier directory.

Fred Meyer Pharmacy #390

DMEPOS supplier · Tacoma, WAOperated by Fred Meyer Stores Inc

✔

Accepts Medicare assignment

Fred Meyer Pharmacy #390 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20680949

Medicare Participant SinceJuly 1, 1966

Supplier Location4505S 19th StTacoma, WA 98405

Phone(253) 752-9110

Supplier Specialties

Pharmacy Grocery Store

Medicare Product Categories

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Nebulizer Drugs

Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Commodes, Urinals, Bedpans

Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals

Blood Glucose Monitors/Supplies (Non-Mail Order)

Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fred Meyer Pharmacy's NPI number?

The NPI number for Fred Meyer Pharmacy is 1891030300. It was assigned to this organization in the NPPES registry on December 10, 2012.

Where is Fred Meyer Pharmacy located?

Fred Meyer Pharmacy is located at 4505 South 19th, Tacoma, WA 98405. The listed phone number is (253) 752-9110.

What is Fred Meyer Pharmacy's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Does Fred Meyer Pharmacy accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Fred Meyer Pharmacy #390 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Fred Meyer Pharmacy hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D0964315) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fred Meyer Pharmacy was last updated on December 10, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.