Organization
RANDALLS FOOD & DRUGS LP
Active
Parent organization
SAFEWAY INC
Other names
TOM THUMB PHARMACY #2554
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
3100 INDEPENDENCE PKWY, PLANO, TX 75075-9152
(972) 596-4422
(972) 964-5611
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
22167
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4547646
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
463780
—
TX
Enumeration date
06/21/2006
Last updated
11/02/2018
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