Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #1087
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
200 HAMAKUA DR, KAILUA, HI 96734-3985
(808) 266-5220
(808) 266-5213
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
PHY-867
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08601901
—
HI
01
—
2018183
PK
—
Enumeration date
06/21/2006
Last updated
04/30/2020
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