Organization
SAFEWAY INC
Active
Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #4812
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ANN RIVERS CPHT (MANAGED CARE PLAN SPECIALIST)
(623) 869-3524
Entity
Organization
Contact information
Practice address
1101 UNIVERSITY BLVD E, HYANTTSVILLE, MD 20783-4614
(301) 431-3690
(301) 431-3693
Mailing address
PO BOX 60000 FILE NO 74150, SAN FRANCISCO, CA 94160-0001
(623) 869-3524
(623) 869-1232
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
P02483
MD
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2124218
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
923001700
—
MD
Enumeration date
07/02/2006
Last updated
06/24/2009
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