Active NPI
Safeway Inc
Doing business as Safeway Pharmacy #3213
- Community/Retail Pharmacy
- Shoreline, WA
National Provider Identifier
1821453655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHAR.CF.60629345
- Legal business name
- SAFEWAY INC
- Doing business as
- Safeway Pharmacy #3213
- Practice address
- 15332 Aurora Ave N
Shoreline, WA 98133-6125 - Phone
- (206) 539-5500
- Fax
- (206) 539-5505
- NPI assigned
- Dec 21, 2015
- Last updated
- Apr 15, 2020
- 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
- Kathy Giannakopoulos
- Title
- Enrollments Manager
- Phone
- (208) 395-3954
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHAR.CF.60629345 | WA | Primary |
Addresses
Primary practice location
15332 Aurora Ave N
Shoreline, WA 98133-6125
Mailing address
250 E Parkcenter Blvd
Boise, ID 83706-3940
Phone (208) 395-3963
Other names 1
- Safeway Pharmacy #3213
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160623001155 | WA | DME Supplier - Pharmacy | 8628980299 | Practice locations: Shoreline, WA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D2127770 | Safeway Pharmacy #3213 | Certificate of waiver | Apr 4, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Safeway Pharmacy #3213 | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Surgical Dressings | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Safeway Pharmacy 1590
Organizations with this tax ID in the same state 22
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Member of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Genuardi's Pharmacy #3023
- Community/Retail Pharmacy
- Glen Mills, PA
- NPI 1568408185
Member Of
-
dba Tom Thumb Pharmacy #2544
- Community/Retail Pharmacy
- Dallas, TX
- NPI 1366474199
Member Of
Locations
15332 Aurora Ave N
Shoreline, WA 98133
Phone (206) 362-4940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450656000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1586908800000",
"number": "1821453655",
"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": "208-395-3963",
"fax_number": "623-336-6896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15332 AURORA AVE N",
"city": "SHORELINE",
"state": "WA",
"postal_code": "981336125",
"telephone_number": "206-539-5500",
"fax_number": "206-539-5505"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAFEWAY INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-12-21",
"last_updated": "2020-04-15",
"certification_date": "2020-04-15",
"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": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "WA",
"license": "PHAR.CF.60629345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Safeway Pharmacy #3213",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Safeway Pharmacy #3213",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Shoreline, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.