Organization
RANDALLS FOOD & DRUGS LP
Active
Parent organization
SAFEWAY INC.
Other names
Tom Thumb Pharmacy #1854
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAFEWAY INC.
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
4301 CROSS TIMBERS RD., FLOWERMOUND, TX 75022
(972) 691-2151
(972) 691-2195
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
466854
—
TX
Enumeration date
10/11/2012
Last updated
11/01/2018
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