Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #2627
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
3250 LEIF ERIKSON DR, ASTORIA, OR 97103-2637
(503) 338-0291
(503) 325-8664
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0002160
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2079271
PK
—
05
—
213331
—
OR
05
—
275333
—
OR
Enumeration date
07/02/2006
Last updated
10/04/2018
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