Safeway Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PDO.0510000003 Issued in CO

Legal business name

SAFEWAY INC

Practice address

1701 Jackson St
Golden, CO 80401-1925

Phone

(303) 278-2284

Fax

(303) 278-7057

NPI assigned

Jun 21, 2006

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 2

Other names 1

• SAFEWAY PHARMACY #0322 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, CO2 enrollments

Enrollment records 2

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Genuardi'S Family Markets LP (GFM)

  • Community/Retail Pharmacy
  • King of Prussia, PA
  • NPI 1265659361

  Member Of

  NPD member
• Randalls Food & Drugs LP

  • Community/Retail Pharmacy
  • Georgetown, TX
  • NPI 1912419649

  Member Of

  NPD member
• Vons Companies Inc

  • Community/Retail Pharmacy
  • Rancho Santa Margarita, CA
  • NPI 1659300689

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1770529364",
    "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": "1701 JACKSON ST",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804011925",
            "telephone_number": "303-278-2284",
            "fax_number": "303-278-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFEWAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "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": "CO",
            "license": "PDO.0510000003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03765419",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2001525",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAFEWAY PHARMACY #0322",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAFEWAY PHARMACY #0322",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Russell
• Danielle Louise Ruyle
• Maria Ryan, PA-C
• Gregory John Sabatos, RPH.
• Isabella Grace Sackheim, MS
• Rachel Lea Sailer, LICENSED SOCIAL WORK
• Andrea Krumholz Salzberg, MD
• Gabrielle Laine Samo
• Mark Robert Sanazaro, M.D.
• Jeffrey Sanchez

• Community/Retail Pharmacy in Golden, CO
• Providers in Golden, CO by specialty
• Community/Retail Pharmacy in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.

Verify at the official NPI Registry.