Safeway Pharmacy #1139

LBN: Safeway Inc
Safeway Pharmacy #1139 is an health care organization with primary practice located at 90 Fifth St , Douglas AZ 85607. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Safeway Inc can be contacted via phone (520) 364-7568, or through Rivers, Michelle Ann via phone (623) 869-3524.

Contact Information

Primary practice address
90 Fifth St Douglas AZ 85607
Phone: (520) 364-7568
Fax: (520) 364-9053
Website:
Map and Directions
Authorized official contact:
Name: Rivers, Michelle Ann CPHT
Phone: (623) 869-3524

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X P02518 Arizona
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1356370308
LBN Legal business name Safeway Inc
DBA Doing business as Safeway Pharmacy #1139
Authorized official Rivers, Michelle Ann CPHT
Entity Organization
Organization subpart 1 No
Enumeration date Jul 2nd, 2006
Last updated Dec 1st, 2008 - about 18 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 1356370308 NPPES
Arizona MEDICAID 147050
Arizona Other 0320135
Arizona MEDICAID 0016820210004

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