Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #1508
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
3820 RAINIER AVE S, SEATTLE, WA 98118-1159
(206) 725-9887
(206) 725-9942
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60517108
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108952
PK
—
05
—
6009997
—
WA
Enumeration date
07/02/2006
Last updated
04/08/2020
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