Organization
RANDALLS FOOD & DRUGS LP
Active
Organization
RANDALLS FOOD & DRUGS LP
Active
Parent organization
SAFEWAY INC
Other names
TOM THUMB PHARMACY #3589
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAFEWAY INC
Authorized official
MICHELLE ANN RIVERS CPHT (MANAGED CARE PLAN SPECIALIST)
(623) 869-3524
Entity
Organization
Contact information
Practice address
4720 BRYANT IRVIN RD, FT WORTH, TX 76132-3604
(817) 294-9994
(817) 370-6459
Mailing address
20427 N 27TH AVE # MSC4551, PHOENIX, AZ 85027-3241
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
22087
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4573855
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
463763
—
TX
Enumeration date
07/02/2006
Last updated
05/26/2017
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