Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #1864
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
24040 BOTHELL EVERETT HWY, BOTHELL, WA 98021-9342
(425) 482-2829
(425) 482-2879
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-3954
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60520406
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467732735
—
WA
01
—
2131640
PK
—
Enumeration date
08/18/2011
Last updated
04/15/2020
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