Organization
SAFEWAY INC
Active
Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #0695
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
6477 ALMADEN EXPY, SAN JOSE, CA 95120-2902
(408) 323-2013
(408) 323-2022
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83712-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY52316
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710916739
—
CA
01
—
2115693
PK
—
Enumeration date
07/02/2006
Last updated
10/07/2019
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