Organization
CARR-GOTTSTEIN FOODS CO
Active
Other names
SAFEWAY PHARMACY #1832
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
90 STERLING HWY, HOMER, AK 99603-7439
(907) 226-1060
(907) 235-7245
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
401
AK
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202488
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PH2051
—
AK
Enumeration date
07/02/2006
Last updated
03/04/2020
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