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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
1333600000XPharmacy02459CO
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20606369OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
3PHC015OTHERCOFLU #
4P00229889OTHERCORR #

General Provider Information

NPI Number : 1619913225
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAFEWAY INC
Provider Business Mailing Address
First Line : 20427 N 27TH AVE # MSC4551
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-3241
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3335 N ACADEMY BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-5103
Country : US
Telephone Number : 719-574-1560
Fax Number : 719-574-3540
Authorized Official
Title or Position : MANAGED CARE PLAN SPECIALIST
Name : MICHELLE ANN RIVERS
Credential : CPHT
Telephone Number : 623-869-3524
Provider Enumeration Date : 06/21/2006
Last Update Date : 12/15/2008

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Directions to “SAFEWAY INC ” Practice Location

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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.

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