Safeway Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHAR.CF.60515926 Issued in WA

Legal business name

SAFEWAY INC

Practice address

442 W Sims Way
Port Townsend, WA 98368-1811

Phone

(360) 385-2860

Fax

(360) 385-0573

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

Tiffany Eliopulos

Title

Assistant Manager, Enrollments

Phone

(208) 395-3906

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SAFEWAY PHARMACY #0538 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, WA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

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

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heidi Lynn Kane, RPH

  • Pharmacist
  • Port Townsend, WA
  • NPI 1326348137
  NPD (past)
• Quang Duy Nguyen, PHARMD

  • Pharmacist
  • Port Townsend, WA
  • NPI 1861215410

  Community/Retail Pharmacy

  NPD (past)
• David F Oconnor

  • Pharmacist
  • Port Townsend, WA
  • NPI 1013217918
  NPD (past)
• Stacy Ann Olson, RPH

  • Pharmacist
  • Port Townsend, WA
  • NPI 1851699011
  NPD (past)
• Steven Shapiro

  • Pharmacist
  • Port Townsend, WA
  • NPI 1023318029
  NPD (past)
• Kelsey Layne Wert, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Belfair, WA
  • NPI 1598359630
  NPD (past)
• Larry Jason Breakfield, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • New Albany, IN
  • NPI 1821607094
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1881630481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "address_2": "MAILSTOP SEC2-B",
            "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": "442 W SIMS WAY",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983681811",
            "telephone_number": "360-385-2860",
            "fax_number": "360-385-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFEWAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "ELIOPULOS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "ASSISTANT MANAGER, ENROLLMENTS",
        "authorized_official_telephone_number": "208-395-3906"
    },
    "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.60515926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6007017",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108542",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAFEWAY PHARMACY #0538",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAFEWAY PHARMACY #0538",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jesse W Ruffo
• Robin Runyan
• Kathleen Jean Ryan, RPH
• Shannon Elizabeth Ryan, LMP
• Safe Harbor Recovery Center
• Sammi Bair-Jones Physical Therapy, PLLC
• Denise Anne Sample, NP-C
• Heather Sanders, LMT
• Mark Saran, LMHC
• Edward Paul Savidge, DDS

• All providers in Port Townsend, WA
• Community/Retail Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.

Verify at the official NPI Registry.