Active NPI
Safeway Inc
Doing business as Haggen Pharmacy #3438
- Community/Retail Pharmacy
- Auburn, WA
National Provider Identifier
1174978837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHAR.CF.60657868
- Legal business name
- SAFEWAY INC
- Doing business as
- Haggen Pharmacy #3438
- Practice address
- 1406 Lake Tapps Pkwy SE
Auburn, WA 98092-8154 - Phone
- (253) 876-1761
- Fax
- (253) 876-1795
- NPI assigned
- May 2, 2016
- Last updated
- Apr 3, 2020
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHAR.CF.60657868 | WA | Primary |
Addresses
Primary practice location
1406 Lake Tapps Pkwy SE
Auburn, WA 98092-8154
Mailing address
250 E Parkcenter Blvd
Boise, ID 83706-3940
Phone (208) 395-3906
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2064878 | Medicaid | WA | |
| 2159998 | Other | PK |
Other names 1
- Haggen Pharmacy #3438
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160825000936 | WA | DME Supplier - Pharmacy | 8628980299 | Practice locations: Auburn, WA |
National Provider Directory
National Provider Directory- Tax ID family
- Safeway Pharmacy 1234
Organizations with this tax ID in the same state 13
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Member of 3
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Genuardi's Pharmacy #3012
- Community/Retail Pharmacy
- Flourtown, PA
- NPI 1629007687
Member Of
-
dba Tom Thumb Pharmacy #2581
- Community/Retail Pharmacy
- Frisco, TX
- NPI 1366488983
Member Of
-
dba Vons Pharmacy #2209
- Community/Retail Pharmacy
- Lakewood, CA
- NPI 1336178383
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462147200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1585872000000",
"number": "1174978837",
"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",
"telephone_number": "208-395-3906",
"fax_number": "623-336-6896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1406 LAKE TAPPS PKWY SE",
"city": "AUBURN",
"state": "WA",
"postal_code": "980928154",
"telephone_number": "253-876-1761",
"fax_number": "253-876-1795"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAFEWAY INC",
"organizational_subpart": "NO",
"enumeration_date": "2016-05-02",
"last_updated": "2020-04-03",
"certification_date": "2020-04-03",
"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": "WA",
"license": "PHAR.CF.60657868",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2064878",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2159998",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Haggen Pharmacy #3438",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Haggen Pharmacy #3438",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.