Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #0330
Organization subpart
No
Provider details
NPI number
Authorized official
MANAGED CARE CPHT (MANAGED CARE PLAN SPECIALIST)
(925) 467-2806
Entity
Organization
Contact information
Practice address
9517 RALSTON RD, ARVADA, CO 80002
(303) 425-7361
(303) 456-4644
Mailing address
5918 STONERIDGE MALL RD, PLEASANTON, CA 94588-3229
(925) 467-2802
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
40000014
CO
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03765369
—
CO
01
—
0609430
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
P00229889
RAILROAD
—
01
—
PHC015
FLU PROVIDER
—
Enumeration date
06/24/2006
Last updated
06/05/2013
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