Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #1732
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1449 N ARIZONA BLVD, COOLIDGE, AZ 85128-3214
(520) 723-5552
(520) 723-5551
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-6200
(623) 336-6896
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y006171
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132895
—
AZ
01
—
1989474
PK
—
Enumeration date
07/02/2006
Last updated
04/02/2020
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