Organization
RANDALLS FOOD & DRUGS LP
Active
Parent organization
SAFEWAY INC
Other names
TOM THUMB PHARMACY #3623
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
210 E PLEASANT RUN RD, DESOTO, TX 75115-3938
(972) 274-7008
(972) 274-7012
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-3920
(623) 336-6896
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
22094
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4596473
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
463878
—
TX
Enumeration date
06/21/2006
Last updated
10/02/2018
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