Organization
SAFEWAY INC
Active
Organization
SAFEWAY INC
Active
Other names
Safeway Pharmacy #0094
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
10050 BRUCEVILLE RD., ELK GROVE, CA 95757
(916) 479-7020
(916) 479-7202
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3999
(208) 395-3954
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
05/16/2024
Last updated
05/16/2024
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