Organization
SAFEWAY INC
Active
Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #3251
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
20620 HOMESTEAD RD, CUPERTINO, CA 95014-0451
(408) 253-0122
(408) 253-0129
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY52085
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952727729
—
CA
01
—
2144770
PK
—
Enumeration date
03/17/2014
Last updated
04/16/2020
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