# SAFEWAY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SAFEWAY PHARMACY \#2696
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548291362
- **Authorized official:** KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
- **Authorized official phone:** (208) 395-3954

## Contact information

- **Practice address:** 14840 SE WEBSTER RD, MILWAUKIE, OR 97267-3249
- **Practice address phone:** (503) 303-1090
- **Practice address fax:** (503) 303-1075
- **Mailing address:** 250 E PARKCENTER BLVD, BOISE, ID 83706-3940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | RP0002159CS | OR | Yes |

## Other

- **Enumeration date:** 07/06/2006
- **Last updated:** 04/01/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2079275 | PK | — |
| 05 | — | 233006 | — | OR |
| 05 | — | 500649611 | — | OR |