Active NPI
Safeway Inc
- Community/Retail Pharmacy
- Peoria, AZ
National Provider Identifier
1326077397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- SAFEWAY INC
- Practice address
- 20713 N 83Rd Ave
Peoria, AZ 85382-7427 - Phone
- (623) 476-1650
- Fax
- (623) 476-1644
- NPI assigned
- Jul 2, 2006
- 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
- Michelle Rivers, CPHT
- Title
- Managed Care Plan Specialist
- Phone
- (623) 869-3524
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Y03469 | AZ | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
20713 N 83Rd Ave
Peoria, AZ 85382-7427
Mailing address
20427 N 27TH Ave # Msc4551
Phoenix, AZ 85027-3241
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0327141 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 760919 | Medicaid | AZ |
Other names 1
- SAFEWAY PHARMACY # 1955
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040819001277 | TX | Part B Supplier - Centralized Flu Biller | 8628980299 |
This NPI is an additional NPI on the enrollment Practice locations: Boise, ID |
National Provider Directory
National Provider DirectoryMember of 3
Organizations this organization is a member of, according to the National Provider Directory.
-
- Community/Retail Pharmacy
- King of Prussia, PA
- NPI 1265659361
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1232323200000",
"number": "1326077397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20427 N 27TH AVE # MSC4551",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850273241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20713 N 83RD AVE",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853827427",
"telephone_number": "623-476-1650",
"fax_number": "623-476-1644"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAFEWAY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-02",
"last_updated": "2009-01-19",
"status": "A",
"authorized_official_last_name": "RIVERS",
"authorized_official_first_name": "MICHELLE",
"authorized_official_title_or_position": "MANAGED CARE PLAN SPECIALIST",
"authorized_official_telephone_number": "623-869-3524",
"authorized_official_credential": "CPHT"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "AZ",
"license": "Y03469",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "0327141",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "760919",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SAFEWAY PHARMACY # 1955",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2009; 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.