Provider Information for 1396355681
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SAFEWAY INC
Other Names:Doing Business As:CARRS PHARMACY #1739Organization Subpart: NO
NPI: 1396355681
Last Updated: 2020-08-03
Certification Date: 2020-08-03
Certification Date: 2020-08-03
Details
Name | Value | ||||||||||||
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NPI | 1396355681 | ||||||||||||
Enumeration Date | 2020-08-03 | ||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||
Status | Active | ||||||||||||
Authorized Official Information | Name: KATHY GIANNAKOPOULOS Title: ENROLLMENTS MANAGER Phone: 2083953954 | ||||||||||||
Mailing Address | 250 E PARKCENTER BLVD BOISE, ID 83706-3940 United States Phone: 208-395-6200 | Fax: | ||||||||||||
Primary Practice Address | 664 W PALMER WASILLA HWY PALMER, AK 99645-6535 United States Phone: 907-761-1460 | Fax:907-761-1419 | ||||||||||||
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