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General NPI Number Information
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NPI Number | 1841670742
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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 | 06/05/2015
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Last Update Date | 06/05/2015
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Provider Practice Location Address
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Address Line | 2980 E CAPITOL EXPY
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City | SAN JOSE
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State | CA
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Zip | 95148-4246
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Country | US
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Telephone | 408-274-5939
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Fax | 408-274-5954
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Provider Business Mailing Address
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Address Line | 2980 E CAPITOL EXPY
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City | SAN JOSE
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State | CA
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Zip | 95148-4246
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Country | US
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Telephone | 408-274-5939
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Fax | 408-274-5954
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Authorized Official
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Title or Position | DISTRICT MANAGER
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Name | MS. MARLA NOLAN
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Credential | PHARM.D
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Telephone | 925-519-8120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 50098
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License Number State | CA
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