Organization
SAFEWAY INC
Active
Other names
SAFEWAY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE RIVERS CPHT (MANAGED CARE ANALYST)
(623) 869-3524
Entity
Organization
Contact information
Practice address
225 MAPLE AVE E, VIENNA, VA 22180-4630
(703) 281-0501
(703) 319-0194
Mailing address
20427 N 27TH AVE MSC 4501, PHOENIX, AZ 85027-3241
(623) 869-3524
(623) 869-1232
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
201002846
VA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4825278
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8536201
—
VA
Enumeration date
07/02/2006
Last updated
07/07/2008
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