Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #2341
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
620 W PLATTE AVE, FORT MORGAN, CO 80701-2652
(970) 867-3027
(970) 867-6580
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83712-3940
(208) 395-6200
(623) 336-6896
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PDO.0460000007
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03002110
—
CO
01
—
2002181
PK
—
Enumeration date
07/02/2006
Last updated
10/17/2018
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