NPIMap

Organization Active NPI

Safeway

  • Community/Retail Pharmacy
  • Medford, OR
National Provider Identifier
1083160147
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0015445 Issued in OR
Legal business name
SAFEWAY
Practice address
2001 Table Rock Rd
Apt 28
Medford, OR 97501-1483
Phone
(541) 660-7657
NPI assigned
Aug 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sean Clark
Title
RPH
Phone
(541) 660-7657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 0015445 OR Primary

Addresses

Primary practice location

2001 Table Rock Rd
Apt 28
Medford, OR 97501-1483

Mailing address

2001 Table Rock Rd
Apt 28
Medford, OR 97501-1483
Phone (541) 660-7657

National Provider Directory

National Provider Directory
Tax ID family
Safeway Pharmacy 107370 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 3

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1083160147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 TABLE ROCK RD",
            "address_2": "APT 28",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975011483",
            "telephone_number": "541-660-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 TABLE ROCK RD",
            "address_2": "APT 28",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975011483",
            "telephone_number": "541-660-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFEWAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "RPH",
        "authorized_official_telephone_number": "541-660-7657"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "0015445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.