Safeway Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SAFEWAY INC

Practice address

5111 Westfields Blvd
Centreville, VA 20120-4365

Phone

(703) 631-5292

Fax

(703) 502-0687

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

Michelle Ann Rivers, CPHT

Title

Managed Care Plan Specialist

Phone

(623) 869-3524

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SAFEWAY PHARMACY #1081 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228089600000",
    "number": "1770529398",
    "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": "5111 WESTFIELDS BLVD",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201204365",
            "telephone_number": "703-631-5292",
            "fax_number": "703-502-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFEWAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-12-01",
        "status": "A",
        "authorized_official_last_name": "RIVERS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MANAGED CARE PLAN SPECIALIST",
        "authorized_official_telephone_number": "623-869-3524",
        "authorized_official_credential": "CPHT"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "201002630",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8530335",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4823515",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAFEWAY PHARMACY #1081",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rex B Ruiz, MD
• Julie Marie Rund, LPC, ATR
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• Courtney Katherine Ryan, MD
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• Abdul Latif Satary
• Patricia Schnabel, BCBA
• Maureen Weismann Schultheis

• Community/Retail Pharmacy in Centreville, VA
• Providers in Centreville, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.