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FRED MEYER PHARMACY
NPI 1902841075
Pharmacy - Community/Retail Pharmacy in Portland, OR

Active since June 20, 2006CLIA 38D0909459 · Waiver
3805 SE HAWTHORNE BLVD, PORTLAND, OR 97214(503) 234-7559(503) 872-3327 Get Directions Write a Review

NPPES record last updated: May 16, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Fred Meyer Pharmacy NPPES

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

FRED MEYER PHARMACY (NPI 1902841075) is a healthcare organization registered as a community/retail pharmacy in Portland, Oregon and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through August 8, 2026 and lists Allison Muennich, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1902841075
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameFRED MEYER STORES INC
Location Address3805 SE HAWTHORNE BLVDPortland, OR 97214-5239
Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092
Phone(503) 234-7559
Fax(503) 872-3327
Organization SubpartNo
Authorized OfficialAllison MuennichManager Of Pharmacy Licensing · (513) 762-1019
Enumeration DateJune 20, 2006
Last NPPES UpdateMay 16, 2016
✔ NPI 1902841075 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 OR · RP0000058CS
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
3805 SE HAWTHORNE BLVD, Portland, OR 97214
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Other Names 1

Doing Business AsFred Meyer Pharmacy

Other Identifiers 5

Medicare PINR149649
Medicare PIN870023642
Medicare NSC0509530014
Medicaid064170OR
Other2077379Pk

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 38D0909459

Fred Meyer Pharmacy #135 · Portland, OR
Active · expires Aug 8, 2026
CLIA Number38D0909459
Laboratory TypePharmacy
Certificate Effective DateAugust 9, 2024
Certificate Expiration DateAugust 8, 2026
Laboratory DirectorIan Wood
Laboratory Phone(503) 234-7559
Laboratory LocationFred Meyer Pharmacy #1353805 SE Hawthorne Blvd, Portland, OR 97214
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 2

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.
160 services160 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.
153 services153 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Fred Meyer Pharmacy #40 carries, from the Medicare DMEPOS supplier directory.

Fred Meyer Pharmacy #40

DMEPOS supplier · Portland, OROperated by Fred Meyer Stores Inc
✔

Accepts Medicare assignment

Fred Meyer Pharmacy #40 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)20680805
Medicare Participant SinceJuly 1, 1966
Supplier Location7555swbarbur BlvdPortland, OR 97219
Phone(503) 452-3033
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.

Other Providers at the Same Location NPPES 3

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

HONGNGOC T NGUYEN PHARM.D.
Pharmacist
3805 SE HAWTHORNE BLVD
PORTLAND, OR 97214
Multnomah County (503) 872-3333
RYAN EIDAR PIMENTEL RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3805 SE HAWTHORNE BLVD
PORTLAND, OR 97214
Multnomah County (503) 872-3333
DR. CODY ANDREW AICHELE PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3805 SE HAWTHORNE BLVD
PORTLAND, OR 97214
Multnomah County (503) 872-3333

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 Stores Inc's NPI number?

The NPI number for Fred Meyer Stores Inc is 1902841075. It was assigned to this organization in the NPPES registry on June 20, 2006. The provider is doing business as Fred Meyer Pharmacy.

Where is Fred Meyer Stores Inc located?

Fred Meyer Stores Inc is located at 3805 SE Hawthorne Blvd, Portland, OR 97214. The listed phone number is (503) 234-7559.

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.

Does Fred Meyer Stores Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Fred Meyer Pharmacy #40 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Fred Meyer Stores Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D0909459) is associated with this NPI, valid through August 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Fred Meyer Stores Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and Ambetter from Arkansas Health & Wellness and 44 other insurers list Fred Meyer Stores Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fred Meyer Stores Inc was last updated on May 16, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.