Safeway Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0000979 Issued in OR

Legal business name

SAFEWAY INC

Doing business as

Safeway Pharmacy #1047

Practice address

17779 Lower Boones Ferry Rd
Lake Oswego, OR 97035-5237

Phone

(503) 675-2509

Fax

(503) 675-2512

NPI assigned

Jun 21, 2006

Last updated

Apr 6, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathy Giannakopoulos

Title

Enrollments Manager

Phone

(208) 395-3954

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• SAFEWAY PHARMACY #1047 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, OR2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Genuardi's Family Markets LP GFM

  dba Genuardi's Pharmacy #3012

  • Community/Retail Pharmacy
  • Flourtown, PA
  • NPI 1629007687

  Member Of

  NPD member
• Randalls Food & Drugs LP

  dba Tom Thumb Pharmacy #2581

  • Community/Retail Pharmacy
  • Frisco, TX
  • NPI 1366488983

  Member Of

  NPD member
• Vons Companies Inc

  dba Vons Pharmacy #2209

  • Community/Retail Pharmacy
  • Lakewood, CA
  • NPI 1336178383

  Member Of

  NPD member

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katherine Eva Blezinski, RPH

  • Pharmacist
  • Lake Oswego, OR
  • NPI 1003118233
  NPD (past)
• Samuel Allen Cutting, RPH

  • Pharmacist
  • Lake Oswego, OR
  • NPI 1033072616
  NPD (past)
• David Jong, PHARMD

  • Pharmacist
  • Lake Oswego, OR
  • NPI 1003685876

  Pharmacy

  NPD (past)
• Shah N Malik, R.PH.

  • Pharmacist
  • Lake Oswego, OR
  • NPI 1487956231
  NPD (past)
• Kelly Kim Nguyen, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Lake Oswego, OR
  • NPI 1699242693
  NPD (past)
• Ngoc Que To, RPH

  • Pharmacist
  • Beaverton, OR
  • NPI 1568748051
  NPD (past)
• Deborah Sue Verzasconi

  • Pharmacist
  • Lake Oswego, OR
  • NPI 1942501515
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586131200000",
    "number": "1144266917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17779 LOWER BOONES FERRY RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355237",
            "telephone_number": "503-675-2509",
            "fax_number": "503-675-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFEWAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A",
        "authorized_official_last_name": "GIANNAKOPOULOS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ENROLLMENTS MANAGER",
        "authorized_official_telephone_number": "208-395-3954"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "0000979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150359",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2077927",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269252",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAFEWAY PHARMACY #1047",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAFEWAY PHARMACY #1047",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Mary Rust, L.P.C.
• Ryan Randol DDS PC
• Christine Ryu, MD
• Jon-Michael Anthony Saenz, MD
• Nikole Safarov
• Safeway Inc (Safeway Pharmacy #0508)
• Cornell Saftencu
• Hooshang K Saifkhani, RN
• Rhea Saini
• Graciela Salamanca

• Community/Retail Pharmacy in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Community/Retail Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.