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Organization

RANDALLS FOOD & DRUGS LP

Active
Parent organization
SAFEWAY INC
Other names
TOM THUMB PHARMACY #1540
Organization subpart
Yes

Provider details

NPI number
Legal business name
SAFEWAY INC
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization

Contact information

Practice address
3757 FOREST LANE, DALLAS, TX 75234-7127
(972) 241-7442
(972) 484-1004
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
22165
TX
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4570481
OTHER ID NUMBER-COMMERCIAL NUMBER
05
463775
TX
Enumeration date
07/02/2006
Last updated
10/29/2018
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