Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #1269
Organization subpart
No
Provider details
NPI number
Authorized official
SUNNY YOST CPHT (MANAGED CARE PLAN SPECIALIST)
(925) 467-2806
Entity
Organization
Contact information
Practice address
1541 NE 181ST ST, PORTLAND, OR 97230-6721
(503) 665-2565
(503) 665-3307
Mailing address
5918 STONERIDGE MALL RD, PLEASANTON, CA 94588-3229
(925) 467-2811
(925) 467-2802
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
RP-0001117
OR
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008982
—
OR
01
—
3810238
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/06/2006
Last updated
06/06/2014
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