Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #3523
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
14826 HIGHWAY 99, LYNNWOOD, WA 98087-2322
(425) 743-6808
(425) 742-8595
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
(208) 395-3963
(623) 336-6896
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60520910
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108068
PK
—
05
—
6116404
—
WA
Enumeration date
06/21/2006
Last updated
10/03/2018
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