NPIMap

Organization Active NPI

Carr-Gottstein Foods Co

Doing business as Safeway Pharmacy #1832

  • Community/Retail Pharmacy
  • Homer, AK
National Provider Identifier
1912936956
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CARR-GOTTSTEIN FOODS CO
Doing business as
Safeway Pharmacy #1832
Practice address
90 Sterling Hwy
Homer, AK 99603-7439
Phone
(907) 226-1060
Fax
(907) 235-7245
NPI assigned
Jul 2, 2006
Last updated
Mar 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 401 AK
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

90 Sterling Hwy
Homer, AK 99603-7439

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other identifiers 2

IdentifierTypeStateIssuer
PH2051MedicaidAK
0202488OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • SAFEWAY PHARMACY #1832 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040820000379 TX Part B Supplier - Centralized Flu Biller 2860466489 18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID
O20100930065686 AK DME Supplier - PharmacyDME Supplier - Grocery Store 2860466489 Practice locations: Homer, AK

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

Member of 1

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

  • Safeway Inc

    dba Safeway Phamracy #4837

    • Community/Retail Pharmacy
    • District Heights, MD
    • NPI 1588600191

    Member Of

    NPD member

Locations

90 Sterling Hwy
Homer, AK 99603
Phone (907) 226-1060

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1912936956",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 STERLING HWY",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037439",
            "telephone_number": "907-226-1060",
            "fax_number": "907-235-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARR-GOTTSTEIN FOODS CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "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": "AK",
            "license": "401",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PH2051",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0202488",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAFEWAY PHARMACY #1832",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Homer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.