Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #2255
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
HWY 95 AND ARMORY, HAWTHORNE, NV 89415
(775) 945-3045
(775) 945-1829
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-3963
(623) 336-6896
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH00688
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225057250
—
NV
01
—
2056548
PK
—
Enumeration date
07/19/2006
Last updated
04/07/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us