# SAFEWAY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DOMINICKS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922037985
- **Authorized official:** PATRICK HARRIS CPHT MBA (MANAGED CARE ANALYST)
- **Authorized official phone:** (623) 869-3778

## Contact information

- **Practice address:** 1968 SIBLEY BLVD, CALUMET CITY, IL 60409-2115
- **Practice address phone:** (708) 730-0061
- **Practice address fax:** (708) 832-9274
- **Mailing address:** 20427 N 27TH AVE MSC 4501, PHOENIX, AZ 85027-3241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 54012096 | IL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1453276 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |