Organization
RANDALLS FOOD & DRUGS LP
Active
Parent organization
SAFEWAY INC
Other names
RANDALLS PHARMACY #1057
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
4540 KINGWOOD DR, KINGWOOD, TX 77345-2600
(281) 360-1888
(281) 360-6341
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
22102
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4587703
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
463639
—
TX
Enumeration date
07/02/2006
Last updated
10/17/2018
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