Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #2909
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ANN RIVERS CPHT (MANAGED CARE PLAN SPECIAIST)
(623) 869-3524
Entity
Organization
Contact information
Practice address
707 E SOUTH BOULDER RD, LOUISVILLE, CO 80027-1327
(303) 665-2025
(303) 665-2829
Mailing address
20427 N 27TH AVE # MSC4551, PHOENIX, AZ 85027-3241
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0812
CO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03765351
—
CO
01
—
0608870
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/21/2006
Last updated
01/19/2009
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