Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #4504
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE RIVERS (MANAGED CARE PLAN SPECIALIST)
(623) 869-3524
Entity
Organization
Contact information
Practice address
1815 WISCONSIN AVE NW, WASHINGTON, DC 20007-2302
(202) 333-6048
(202) 333-8318
Mailing address
20427 N 27TH AVE # MS 4551, PHOENIX, AZ 85027-3241
(623) 869-3524
(623) 869-1232
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
DC
3336C0003X
Community/Retail Pharmacy
Primary
—
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033588600
—
DC
01
—
0904599
NCPDP
DC
Enumeration date
04/17/2009
Last updated
06/16/2010
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