NPI 1649509415 · live from the CMS NPI Registry
Safeway INC
Pharmacy, Community/Retail Pharmacy in Lander, WY. National Provider Identifier 1649509415, active.
NPI record
| NPI | 1649509415 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 1165 Main St, Lander, WY 82520 |
| Practice phone | 307-332-3939 |
| Mailing address | 250 E Parkcenter Blvd, Boise, ID 83706 |
| Enumerated | December 8, 2009 |
| Last updated | April 21, 2020 |
| Authorized official | Kathy Giannakopoulos, Enrollments Manager |
| Other names | Safeway Pharmacy #2761 |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | R10132 (WY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.