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General NPI Number Information
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NPI Number | 1831566694
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Entity Type | Organization
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Legal Business Name | SAFEWAY PHARMACY
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 08/27/2015
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Provider Practice Location Address
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Address Line | 20227 N 27TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85027-3242
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Country | US
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Telephone | 623-869-5645
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Fax |
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Provider Business Mailing Address
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Address Line | 20227 N 27TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85027-3242
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Country | US
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Telephone | 623-869-5645
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. TREVOR MATTHEW STUPEY
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Credential | PHARM.D.
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Telephone | 928-380-5142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | S021526
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License Number State | AZ
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