Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #2878
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
525 EL CAMINO REAL, MILLBRAE, CA 94030-2030
(650) 652-3477
(650) 652-3921
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY52469
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528405065
—
CA
01
—
2140492
PK
—
Enumeration date
05/23/2013
Last updated
04/06/2020
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