Organization
SAFEWAY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN SUE DIVELBISS (PHARMACY TECH)
(928) 778-3098
Entity
Organization
Contact information
Practice address
450 WHITE SPAR RD, PRESCOTT, AZ 86303-4626
(928) 778-3098
Mailing address
4791 S JUNIPER LOOP RD, PRESCOTT, AZ 86303-6160
(928) 776-0286
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
3306
AZ
Other
Enumeration date
03/21/2007
Last updated
08/22/2020
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