Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #0548
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
44428 STERLING HWY, SOLDOTNA, AK 99669-8033
(907) 714-5460
(907) 714-5419
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
396
AK
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0226313
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PH0548
—
AK
Enumeration date
07/02/2006
Last updated
04/06/2020
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