Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #2201
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
4860 PECOS ST, DENVER, CO 80221-1513
(303) 433-5083
(303) 477-9539
Mailing address
20427 N 27TH AVE # MSC4551, PHOENIX, AZ 85027-3241
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
198
CO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03000775
—
CO
01
—
0612970
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
P00229889
RR #
CO
01
—
PHC015
FLU #
CO
Enumeration date
07/02/2006
Last updated
12/11/2008
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