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Organization

SAFEWAY INC

Active
Other names
Haggen Pharmacy #3444
Organization subpart
No

Provider details

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

Contact information

Practice address
1313 COOPER POINT RD SW, OLYMPIA, WA 98502-5729
(360) 754-1504
(360) 754-1782
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-3906
(623) 336-6896

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60657838
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2062860
WA
01
2160016
PK
Enumeration date
05/04/2016
Last updated
04/14/2020
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