NPIMap

Organization Active NPI

Safeway Pharmacy

  • Pharmacy Technician
  • Prescott, AZ
National Provider Identifier
1437275518
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
3306 Issued in AZ
Legal business name
SAFEWAY PHARMACY
Practice address
450 White Spar Rd
Prescott, AZ 86303-4626
Phone
(928) 778-3098
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Vivian Sue Divelbiss
Title
Pharmacy Tech
Phone
(928) 778-3098

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 183700000X 3306 AZ Primary

Addresses

Primary practice location

450 White Spar Rd
Prescott, AZ 86303-4626

Mailing address

4791 S Juniper Loop Rd
Prescott, AZ 86303-6160
Phone (928) 776-0286

National Provider Directory

National Provider Directory
Tax ID family
Safeway Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437275518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4791 S JUNIPER LOOP RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863036160",
            "telephone_number": "928-776-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WHITE SPAR RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034626",
            "telephone_number": "928-778-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFEWAY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIVELBISS",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PHARMACY TECH",
        "authorized_official_telephone_number": "928-778-3098"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacy Technician",
            "state": "AZ",
            "license": "3306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.