Organization
RANDALLS FOOD & DRUGS LP
Active
Organization
RANDALLS FOOD & DRUGS LP
Active
Parent organization
SAFEWAY INC
Other names
TOM THUMB PHARMACY # 2643
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
14280 MARSH LN, ADDISON, TX 75001-3857
(972) 241-4532
(972) 241-4136
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
22145
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4517819
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
463776
—
TX
Enumeration date
07/02/2006
Last updated
10/04/2018
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