Safeway Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

40536RP Issued in ID

Legal business name

SAFEWAY INC

Doing business as

Safeway Pharmacy #1470

Practice address

121 W Neider Ave
Coeur D Alene, ID 83815-9300

Phone

(208) 765-4410

Fax

(208) 765-0451

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 #1470 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, ID2 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 #1005

  • Community/Retail Pharmacy
  • Maple Glen, PA
  • NPI 1801034640

  Member Of

  NPD member
• Randalls Food & Drugs LP

  dba Randalls Pharmacy #1896

  • Community/Retail Pharmacy
  • Cedar Park, TX
  • NPI 1356387971

  Member Of

  NPD member
• Vons Companies Inc

  dba Vons Pharmacy #2200

  • Community/Retail Pharmacy
  • Monrovia, CA
  • NPI 1376589986

  Member Of

  NPD member

Locations

Practitioners 3

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.

• Katlin May Cicchetti, PHARMD

  • Pharmacist
  • Coeur d'Alene, ID
  • NPI 1154848547
  NPD (past)
• Ronald Edward Nelson

  • Pharmacist
  • Coeur d'Alene, ID
  • NPI 1205136918
  NPD (past)
• Nancy Ann Rowen, PHARMD

  • Pharmacist
  • Canon City, CO
  • NPI 1376321349
  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": "1164468781",
    "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": "121 W NEIDER AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159300",
            "telephone_number": "208-765-4410",
            "fax_number": "208-765-0451"
        }
    ],
    "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "40536RP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164468781",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2021426",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0034868",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAFEWAY PHARMACY #1470",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAFEWAY PHARMACY #1470",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas P Ryan, NP
• Aaron Sadowsky
• David Marshal Saelens, MPT
• Safe Harbor Counseling Center LLC
• Safe Waters Mental Recovery PLLC
• Safeway Inc (Safeway Pharmacy #3295)
• Sage and Pine Counseling, LLC
• Linda M Sakai, MD
• Kaeleigh Salian
• William Harry Sammond, MD

• Community/Retail Pharmacy in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Community/Retail Pharmacy in Idaho

• 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.