Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #1439
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
785 E EL CAMINO REAL, SUNNYVALE, CA 94087-2919
(408) 481-3302
(408) 481-3305
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
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY52466
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871539486
—
CA
01
—
2076755
PK
—
Enumeration date
06/21/2006
Last updated
10/26/2018
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