Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #2729
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (MANAGER, ENROLLMENTS)
(208) 395-3954
Entity
Organization
Contact information
Practice address
708 SHAW RD, PUYALLUP, WA 98372-5276
(253) 251-5115
(253) 251-5116
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
—
—
Other
Enumeration date
08/09/2019
Last updated
12/13/2019
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