Organization
ALBERTSONS LLC
Active
Other names
Safeway Pharmacy #4406
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
11330 51ST AVE NW, GIG HARBOR, WA 98332-7890
(253) 853-4755
(253) 853-1680
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60342732
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2107335
PK
—
05
—
6025399
—
WA
Enumeration date
05/30/2006
Last updated
03/22/2025
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