Organization
SAFEWAY INC
Active
Other names
Haggen Pharmacy #3439
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1401 12TH ST, BELLINGHAM, WA 98225-7417
(360) 733-9277
(360) 714-8142
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-3906
(623) 336-6896
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60657845
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2061775
—
WA
01
—
2160000
PK
—
Enumeration date
05/02/2016
Last updated
04/22/2020
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