Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #1660
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
905 E MEAD AVE, YAKIMA, WA 98903-3721
(509) 248-8782
(509) 248-6425
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60517970
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110613
PK
—
05
—
6022594
—
WA
Enumeration date
07/06/2006
Last updated
10/29/2018
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