Safeway Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHAR.CF.60515917 Issued in WA

Legal business name

SAFEWAY INC

Practice address

19651 State Route 2
Monroe, WA 98272-1537

Phone

(360) 794-9644

Fax

(360) 794-0734

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 #0537 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

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": "1982640587",
    "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": "19651 STATE ROUTE 2",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721537",
            "telephone_number": "360-794-9644",
            "fax_number": "360-794-0734"
        }
    ],
    "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.60515917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6016018",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108345",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAFEWAY PHARMACY #0537",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAFEWAY PHARMACY #0537",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bonnie Russell
• Hannah Russell
• Brian Joseph Russon, M.S.P.T.ATC
• Alyson Lynette Ryan, APRN
• Sindura Sadanandan, MS, LMHCA
• Sage Mountain Acupuncture, PLLC
• Brenda Helen Samples, OTR/L
• Aiden Savoie-Gavosto, LMP
• George Graham Sayre, PSY.D.
• Evelyn Lee Scarborough

• Community/Retail Pharmacy in Monroe, WA
• Providers in Monroe, WA by specialty
• 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.