FRED MEYER PHARMACY – Community/Retail Pharmacy, NPI 1710922109

FRED MEYER PHARMACY is a healthcare provider. based in Boston, Massachusetts. specializing in Community/Retail Pharmacy. The organization holds a License No. RP0000987CS (OR). The NPI Number for FRED MEYER PHARMACY is 1710922109

Main info

Organization
Name
FRED MEYER PHARMACY
NPI
1710922109
Phone
(513) 762-1019
Address
P.O. BOX 842772
Authorized Official
ALLISON MUENNICH MANAGER OF PHARMACY LICENSING
Enumeration Date
18 June 2006
Last Update Date
19 September 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness90
Years active:19State licenses:1Digital endpoints

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Provider Addresses for FRED MEYER PHARMACY

  • P.O. BOX 842772

    BOSTON, MA 02284

    Phone: (513) 762-1019

    Fax: (513) 762-1092

    Type: Mailing

  • 150, Northeast 20th Street, Nye Beach, Newport, Lincoln County, Oregon, 97365, United States

    NEWPORT, OR 973651851

    Phone: (541) 265-4625

    Fax: (541) 272-3301

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-10-31 (228 days ago).

Enrollment records

2

Earliest due date

2025-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040220000332OMass Immunization (Roster Biller Only)OR2025-10-31
O20100930077025OPharmacyORTBD

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0008Administration of influenza virus vaccine557553$0
90662Influenza vaccine split virus, preservative free535534$0
90480Admn sarscov2 vacc 1 dose454454$0
91322Sarscov2 vac 50 mcg/0.5ml im376376$0
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count23834$0
View full utilization report →

Insurance plans in this area (ZIP 02284)

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Reviews

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Frequently asked questions

What federal number belongs to FRED MEYER PHARMACY?
The federal identifier for FRED MEYER PHARMACY is NPI 1710922109.
Does this profile mean FRED MEYER PHARMACY is currently active?
Yes — FRED MEYER PHARMACY appears active in the national provider directory.
Can you summarize FRED MEYER PHARMACY's specialty in plain language?
Clinically, the directory lists FRED MEYER PHARMACY with Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Where does public data place FRED MEYER PHARMACY?
The snapshot lists Boston, Massachusetts for FRED MEYER PHARMACY; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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