Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #1248
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
2660 FEDERAL BLVD, DENVER, CO 80211-4717
(303) 477-1470
(303) 477-1569
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PDO.0000000187
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03000569
—
CO
01
—
2001997
PK
—
Enumeration date
06/21/2006
Last updated
04/06/2020
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