Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #2791
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
181 W MINERAL AVE, LITTLETON, CO 80120-5691
(303) 218-2104
(303) 218-2105
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
PDO0000000712
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997772
PK
—
05
—
48004383
—
CO
Enumeration date
11/08/2007
Last updated
04/13/2020
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