Safeway Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y006172 Issued in AZ

Legal business name

SAFEWAY INC

Doing business as

Safeway Pharmacy #1733

Practice address

900 W Deuce of Clubs
Show Low, AZ 85901-6214

Phone

(928) 532-5659

Fax

(928) 532-5665

NPI assigned

Jul 2, 2006

Last updated

Apr 8, 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 3

Addresses

Other identifiers 2

Other names 1

• SAFEWAY PHARMACY #1733 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, AZ2 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

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1184653123",
    "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": "208-395-6200",
            "fax_number": "623-336-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W DEUCE OF CLUBS",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859016214",
            "telephone_number": "928-532-5659",
            "fax_number": "928-532-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFEWAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y006172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307183",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1989020",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAFEWAY PHARMACY #1733",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAFEWAY PHARMACY #1733",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen Rogers
• Michael Edward Roman, RPH
• Ronney L. Ferguson, M.D., P.C.
• RTG Medical
• Kristine Rumzis, LPC
• Jaun Sanchez
• Jose Santiago-Cardona
• Ashley Brooke Sarchet, RN
• Michael J Sassmann, PA-C
• Elaine Denise Sawyers, MSW

• Community/Retail Pharmacy in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.