Active NPI
Safeway Inc
Doing business as Haggen Pharmacy #3498
- Community/Retail Pharmacy
- Woodinville, WA
National Provider Identifier
1871948240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHAR.CF.60657798
- Legal business name
- SAFEWAY INC
- Doing business as
- Haggen Pharmacy #3498
- Practice address
- 17641 Garden Way NE
Woodinville, WA 98072-3535 - Phone
- (425) 398-6710
- Fax
- (425) 398-6728
- NPI assigned
- May 4, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHAR.CF.60657798 | WA | Primary |
Addresses
Primary practice location
17641 Garden Way NE
Woodinville, WA 98072-3535
Mailing address
250 E Parkcenter Blvd
Boise, ID 83706-3940
Phone (208) 395-3906
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2159989 | Other | PK | |
| 2062690 | Medicaid | WA |
Other names 1
- Haggen Pharmacy #3498
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161001000016 | WA | DME Supplier - Pharmacy | 8628980299 | Practice locations: Woodinville, WA |
National Provider Directory
National Provider Directory- Tax ID family
- Safeway Pharmacy 1073
Organizations with this tax ID in the same state 20
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Member of 3
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Genuardis Pharmacy #1007
- Community/Retail Pharmacy
- King of Prussia, PA
- NPI 1265659361
Member Of
-
dba Randalls Pharmacy #2484
- Community/Retail Pharmacy
- Georgetown, TX
- NPI 1912419649
Member Of
-
dba Pavilions Pharmacy #2217
- Community/Retail Pharmacy
- Rancho Santa Margarita, CA
- NPI 1659300689
Member Of
Locations
17641 Garden Way NE
Woodinville, WA 98072
Phone (425) 398-6710
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1587427200000",
"number": "1871948240",
"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": "208-395-3906",
"fax_number": "623-336-6896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17641 GARDEN WAY NE",
"city": "WOODINVILLE",
"state": "WA",
"postal_code": "980723535",
"telephone_number": "425-398-6710",
"fax_number": "425-398-6728"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAFEWAY INC",
"organizational_subpart": "NO",
"enumeration_date": "2016-05-04",
"last_updated": "2020-04-21",
"certification_date": "2020-04-21",
"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": "WA",
"license": "PHAR.CF.60657798",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2159989",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2062690",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Haggen Pharmacy #3498",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Haggen Pharmacy #3498",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Woodinville, WA
- Ahana Roy, MD FACP
- Elizabeth Ann Rutledge, RD
- Daniel J. Ryan, DDS
- S.S. Virk & Associates Inc. (Advanced Eyecare Solutions of Woodinville)
- Safeway Inc (Safeway Pharmacy #0533)
- Saman Saghafi, DDS
- Christopher R Salud, OD
- Daniel Marks Salzer, PH.D.
- Saman Saghafi DDS (Smiles to Remember)
- Adilia Rachel Sapp, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.