Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #1684
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1940 E BROADWAY BLVD, TUCSON, AZ 85719-5934
(520) 206-9052
(520) 206-9056
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
Y006167
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181281
—
AZ
01
—
1992505
PK
—
Enumeration date
12/06/2006
Last updated
04/15/2020
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