Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #0353
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE A RIVERS CPHT (MANAGED CARE PLAN SPECIALIST)
(623) 869-3524
Entity
Organization
Contact information
Practice address
3285 COMMERCIAL ST SE, SALEM, OR 97302-4535
(503) 361-3346
(503) 361-3348
Mailing address
20427 N 27TH AVE # MSC4551, PHOENIX, AZ 85027-3241
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
001748
OR
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170389
—
OR
01
—
3813777
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/02/2006
Last updated
11/10/2008
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