Organization
RANDALLS FOOD & DRUGS LP
Active
Organization
RANDALLS FOOD & DRUGS LP
Active
Parent organization
SAFEWAY INC
Other names
TOM THUMB PHARMACY #3312
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAFEWAY INC
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
2400 W 7TH ST, FORT WORTH, TX 76107-2310
(713) 268-3861
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
(208) 395-3920
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APPLIED FOR
NCPDP PROVIDER NO
—
Enumeration date
10/25/2016
Last updated
10/08/2018
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