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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy	PH03057	NV
3	3336C0003X	Community/Retail Pharmacy	Y006109	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1990343	OTHER	PK

General Provider Information

NPI Number	:	1588693543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFEWAY INC

Provider Business Mailing Address
First Line	:	250 E PARKCENTER BLVD
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83706-3940
Country	:	US
Telephone Number	:	208-395-6200
Fax Number	:	623-336-6896

Provider Business Practice Location Address
First Line	:	1751 HWAY 95
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442
Country	:	US
Telephone Number	:	928-763-1888
Fax Number	:	928-763-5186

Authorized Official
Title or Position	:	ENROLLMENTS MANAGER
Name	:	KATHY GIANNAKOPOULOS
Credential	:
Telephone Number	:	208-395-3954

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	03/09/2020

Similar Medicare Providers

1861348914 — JOY MILLS PMHNP-BC
Practice Location Address:

2131 WHITEWATER DR
BULLHEAD CITY, AZ
86442-5235

Practice Phone: 928-542-5086
Practice Fax:

1104772227 — MRS. IVY SEIFER
Practice Location Address:

726 RIVERFRONT DR
BULLHEAD CITY, AZ
86442-6415

Practice Phone: 855-832-6727
Practice Fax:

1588510028 — ASHLEY ANN LAFLAMME LMSW
Practice Location Address:

2206 BREON DR
BULLHEAD CITY, AZ
86442-8630

Practice Phone: 702-758-1970
Practice Fax:

1740283423 — DR. PETER LEOPOLD D.O.
Practice Location Address:

2580 HIGHWAY 95 STE 224
BULLHEAD CITY, AZ
86442-7332

Practice Phone: 928-704-7011
Practice Fax: 928-704-7014

1245233980 — DR. KEVIN FRANK BROWN D.O.
Practice Location Address:

2812 SILVER CREEK RD
BULLHEAD CITY, AZ
86442-8309

Practice Phone: 928-763-7404
Practice Fax: 928-763-9795

1225033483 — PALO VERDE PHYSICAL THERAPY
Practice Location Address:

3003 HIWAY 95 , STE 61
BULLHEAD CITY, AZ
86442-7896

Practice Phone: 928-758-0029
Practice Fax: 928-758-0055

1740286475 — BARRY H LATIMER CRNA
Practice Location Address:

2735 SILVER CREEK RD
BULLHEAD CITY, AZ
86442-7924

Practice Phone: 602-273-6770
Practice Fax: 602-889-0489

Directions to “SAFEWAY INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.