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Organization

RANDALLS FOOD & DRUGS LP

Active
Parent organization
SAFEWAY INC
Other names
TOM THUMB PHARMACY #3617
Organization subpart
Yes

Provider details

NPI number
Legal business name
SAFEWAY INC
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization

Contact information

Practice address
2611 W PARK ROW DR, ARLINGTON, TX 76013-2257
(817) 459-4124
(817) 459-0419
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-3906
(623) 336-6896

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
22091
TX
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4589834
OTHER ID NUMBER-COMMERCIAL NUMBER
05
463771
TX
Enumeration date
07/02/2006
Last updated
10/03/2018
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