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NPI Code Detail

MEDICARE: SAFEWAY INC

MEDICARE: SAFEWAY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy54013005IL
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11447401OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1295764256
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAFEWAY INC
Provider Business Mailing Address
First Line : 20427 N 27TH AVE MSC 4501
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-3241
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5829 S ARCHER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60638-1646
Country : US
Telephone Number : 773-284-0158
Fax Number : 773-284-0278
Authorized Official
Title or Position : MANAGED CARE ANALYST
Name : PATRICK HARRIS
Credential : CPHT MBA
Telephone Number : 623-869-3778
Provider Enumeration Date : 07/02/2006
Last Update Date : 09/11/2025

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Directions to “SAFEWAY INC ” Practice Location

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