| NPI | 1053922393 |
|---|---|
| Doing Business As | SAFEWAY PHARMACY #1513 |
| Entity Type | Organization |
| Authorized Contact | KATHY GIANNAKOPOULOS Enrollmetns Manager 208-395-3954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-08-11 |