Safeway Pharmacy #1576

LBN: Safeway Inc
Safeway Pharmacy #1576 is an health care organization with primary practice located at 2300 Mendocino Ave , Santa Rosa CA 95403-3115. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Safeway Inc can be contacted via phone (707) 569-3111, or through Eliopulos, Tiffany via phone (208) 395-3906.

Contact Information

Primary practice address
2300 Mendocino Ave Santa Rosa CA 95403-3115
Phone: (707) 569-3111
Fax: (707) 569-3115
Website:
Map and Directions
Authorized official contact:
Name: Eliopulos, Tiffany
Phone: (208) 395-3906

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY52321 California

Profile Details

NPI number 1639115249
LBN Legal business name Safeway Inc
DBA Doing business as Safeway Pharmacy #1576
Authorized official Eliopulos, Tiffany
Entity Organization
Organization subpart 1 No
Enumeration date Jun 21st, 2006
Last updated Oct 29th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639115249 NPPES
California MEDICAID 1639115249
California Other 1999631

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