Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #2894
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
4454 NUHOU ST, LIHUE, HI 96766-8018
(808) 246-3680
(808) 246-0143
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY-893
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811378722
—
HI
01
—
2152759
PK
—
Enumeration date
06/16/2015
Last updated
04/15/2020
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