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Organization

SAFEWAY INC

Active
Other names
SAFEWAY PHARMACY #1713
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization

Contact information

Practice address
22000 SALAMO RD, WEST LINN, OR 97068-7230
(503) 650-6426
(503) 650-6724
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-3963
(623) 336-6896

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
0001807
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2079054
PK
05
226309
OR
05
500649633
OR
Enumeration date
07/02/2006
Last updated
04/16/2020
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