Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #1546
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
221 W HERON ST, ABERDEEN, WA 98520-6224
(360) 532-8743
(360) 538-0063
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
PHAR.CF.60517205
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108640
PK
—
05
—
6008098
—
WA
Enumeration date
07/02/2006
Last updated
04/15/2020
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