Organization
SAFEWAY INC
Active
Other names
Safeway Pharmacy #0280
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1090 HOOKELE ST, KAHULUI, HI 96732
(808) 893-0606
(808) 893-0706
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY865
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08716301
—
HI
01
—
2018857
PK
—
Enumeration date
06/21/2006
Last updated
04/08/2020
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