Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #2913
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
2160 W DRAKE RD, FORT COLLINS, CO 80526-1486
(970) 484-2843
(970) 490-2774
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83712-3940
(208) 395-6200
(623) 336-6896
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PDO.0440000005
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03765542
—
CO
01
—
2001629
PK
—
Enumeration date
07/02/2006
Last updated
10/05/2018
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