Organization · Type 2 NPI

Safeway Inc

Community/Retail Pharmacy · Santa Rosa, CA

NPI number 1639115249 Active

Practice location

2300 Mendocino Ave
Santa Rosa, CA 95403-3115

Call (707) 569-3111 Map

Fax (707) 569-3115

Mailing address

250 E Parkcenter Blvd, Mailstop SEC2-B
Boise, ID 83712-3940

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	PHY52321 (CA)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

8 other providers at this address

Other community/retail pharmacy providers in Santa Rosa

See all in Santa Rosa →

NPI record

NPI: 1639115249
Entity type: Organization (Type 2)
Issued: Jun 21, 2006
Last updated: Oct 29, 2018
Status: Active

Other names

<unavail>
Safeway Pharmacy #1576 · doing business as
Safeway Pharmacy #1576 · doing business as

Authorized official

Tiffany Eliopulos
Assistant Manager, Enrollments
(208) 395-3906

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1639115249

Safeway Inc's National Provider Identifier is 1639115249, issued on Jun 21, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Santa Rosa, CA. The record was last updated on Oct 29, 2018.