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Organization

SAFEWAY INC

Active
Other names
SAFEWAY PHARMACY #0531
Organization subpart
No

Provider details

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

Contact information

Practice address
101 AUBURN WAY S, AUBURN, WA 98002-5425
(253) 735-4404
(253) 939-8614
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
PHAR.CF.60515631
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2108361
PK
05
6002810
WA
Enumeration date
06/21/2006
Last updated
04/02/2020
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