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Organization

SAFEWAY INC

Active
Other names
Safeway Pharmacy #0275
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization

Contact information

Practice address
94-809 LUMIAINA ST, WAIPAHU, HI 96797-5025
(808) 664-7730
(808) 664-7731
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

Other

Enumeration date
08/15/2019
Last updated
12/13/2019
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