Safeway Inc
Organization Active NPI Community/Retail Pharmacy · Mountain House, CA
NPI 1992441950 · NPPES record last updated Nov 16, 2022
Key facts
- NPI
- 1992441950
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- SAFEWAY INC
- Practice address
- 19555 S Mountain House Pkwy
Mountain House, CA 95391 - Phone
- (209) 362-1261
- Fax
- (209) 362-1260
- NPI assigned
- May 11, 2022
- Organization subpart
- No
Authorized official
- Name
- Kathy Giannakopoulos
- Title
- Enrollments Manager
- Phone
- (208) 395-3954
Corporate family (same tax ID) 10
Member of 3
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Safeway Pharmacy #0055 |
Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Ostomy Supplies|Urological Supplies|Surgical Dressings | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230120001519 | CA | DME Supplier - Pharmacy |
8628980299 | Practice locations: Mountain House, CA |
National Provider Directory
- Tax ID family
- Safeway Pharmacy 1073
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
19555 S Mountain House Pkwy
Mountain House, CA 95391
Mailing address
250 E Parkcenter Blvd
Boise, ID 83706-3940
Other names
- Safeway Pharmacy #0055
Other providers in Mountain House, CA
- Isabela Loredana Putzlacher
- Trung Ha Quach
- Nirmala Ramachandran
- Tejdeep Singh Rattan
- Safestep Medical LLC
- Eshita Sharma
- Sidhu Brar Dental Group Inc
- Pawanjot Singh
- Beth Sorensen
- Michelle I Steneck
All providers in Mountain House, CA · Community/Retail Pharmacy in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.