SAFEWAY INC (NPI# 1053357822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053357822 |
| Entity Type | Organization |
| Organization Name | SAFEWAY INC |
| Other Organization Name | SAFEWAY PHARMACY #4404 |
| Practice Address |
138 W Ellendale Ave Dallas OR 97338-1408 |
| Mailing Address |
250 E Parkcenter Blvd Mailstop Sec2-b Boise ID 83706-3940 |
| Practice Telephone | 5038316006 |
| Practice Fax Number | 5038316008 |
| Mailing Telephone | 2083953963 |
| Mailing Fax Number | 6233366896 |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2018-09-28 |
| Authorized Official Name | TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS) |
| Authorized Official Telephone | 2083953906 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
0001059 | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 211912 | 05 | |
| PK | 2078039 | 01 | |
| OR | 269299 | 05 |
| Other Name | Type Code |
|---|---|
| SAFEWAY PHARMACY #4404 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033729322 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 2685 Mill Rd, Kodiak, AK 99615-6638 | 2020-08-03 |
| 1396355681 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 664 W Palmer Wasilla Hwy, Palmer, AK 99645-6535 | 2020-08-03 |
| 1467070979 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 75-971 Henry St, Kailua Kona, HI 96740 | 2020-07-10 |
| 1063042083 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 3383 Bass Lake Rd, El Dorado Hills, CA 95762 | 2020-01-17 |
| 1134768286 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 4080 San Pablo Ave, Hercules, CA 94547 | 2020-01-06 |
| 1922654953 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 94-809 Lumiaina St, Waipahu, HI 96797-5025 | 2019-08-15 |
| 1194371526 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 4316 S Signal Butte Rd, Mesa, AZ 85212 | 2019-08-12 |
| 1659926236 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 708 Shaw Rd, Puyallup, WA 98372-5276 | 2019-08-09 |
| 1467928200 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 3680 Crocker Dr, Ste 100, Sacramento, CA 95818 | 2018-10-19 |
| 1831665678 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 717 State Route 9 Ne, Lake Stevens, WA 98258-7992 | 2018-10-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | SAFEWAY INC. | 11555 Dublin Canyon Rd, Pleasanton, CA 94588 |
| New York State Corporations | SAFEWAY INC. | 28 Liberty St., New York, New York 10005 |
| North Carolina Corporations | Safeway Inc. | 2 South Salisbury Street, Raleigh, NC 27601 |
| Oregon Corporations, Companies and Business Names | SAFEWAY INC. | 11555 Dublin Canyon Rd, Pleasanton, CA 94588 |
| Virginia Business Entities | SAFEWAY INC. | 11555 Dublin Canyon Rd, Pleasanton, California 94588 |
| Massachusetts Corporations | SAFEWAY INC. | 5918 Stoneridge Mall Rd., Pleasanton, CA 94588 |
| Washington State Corporations | SAFEWAY INC. | 11555 Dublin Canyon Rd, Pleasanton, CA 94588-2815 |
| Indiana Business Entities | SAFEWAY INC. | 55 Monument Cir, Ste 1424, Indpls, IN 46204 |
| Oklahoma Business Registrations | SAFEWAY INC. | George R Robert, 201 4th Street, Oakland, CA 94660 |
| Vermont Business Registrations | SAFEWAY INC. | 229 South State Street, Dover, DE 19901 |
| Street Address |
138 W ELLENDALE AVE |
| City | DALLAS |
| State | OR |
| Zip Code | 97338-1408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356824908 | Sarah K Brattain | Pharmacist | 138 W Ellendale Ave, Dallas, OR 97338-1408 | 2018-09-10 |
| 1891033247 | David C Zandberg | Pharmacist | 138 W Ellendale Ave, Dallas, OR 97338-1408 | 2013-01-18 |
| 1447536412 | John Mark Kangas | Pharmacist | 138 W Ellendale Ave, Dallas, OR 97338-1408 | 2011-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164932042 | Stephanie Marie Renfro | Massage Therapist | 289 E Ellendale Ave #601, Dallas, OR 97338 | 2017-10-05 |
| 1588185953 | Herbert Starr Woodward IIi | Dentist | 201 Se Washington St, Dallas, OR 97338 | 2017-07-06 |
| 1851708077 | David Mooso | Pharmacist | 321 Nw Kings Valley Highway, Dallas, OR 97338 | 2014-07-21 |
| 1841615556 | Leslie Lytle | Counselor | 1020 Sw Maple St., Dallas, OR 97338 | 2014-03-04 |
| 1205265493 | Chung-fan Ni | Counselor | 182 S. W. Academy St., Academy Building, Dallas, OR 97338 | 2013-11-07 |
| 1215204300 | Ron Fritz | Counselor | 239 E. Ellendale, Suite 602, Dallas, OR 97338 | 2011-11-17 |
| 1235420167 | Deborah Kennedy | Counselor | 527 Ne Fern Ave, Dallas, OR 97338 | 2011-04-26 |
| 1821229774 | Chelsea Ruhoff Lee | Physician Assistant | 1000 Se Uglow Avenue, Flaming Medical Center, Dallas, OR 97338 | 2009-07-27 |
| 1013128560 | Larry J Vuylsteke | Social Worker | 182 S.w. Academy, Dallas, OR 97338 | 2007-05-25 |
| 1093926123 | Justin W Reed | Counselor | Academy Building, 182 S.w. Academy St. Suite 304, Dallas, OR 97338 | 2007-05-24 |
| Find all providers in zip 97338 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | 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 health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407475684 | Pcn Care Pllc | Pharmacy | 3201 W Saner Ave Ste 100, Dallas, TX 75233-1430 | 2020-04-08 |
| 1841824133 | Rite Quality Health Inc | Pharmacy | 18900 Dallas Pkwy Ste 106, Dallas, TX 75287-6916 | 2020-02-26 |
| 1740810852 | Chc Care Specialty Pharmacy and Consultants LLC | Pharmacy | 14211 Coit Rd Ste 1, Dallas, TX 75254-2862 | 2020-01-17 |
| 1770127821 | Methodist Community Pharmacy, LLC | Pharmacy | 3500 W Wheatland Rd Ste B, Dallas, TX 75237-3460 | 2019-11-01 |
| 1144874967 | Capsule Dallas LLC | Pharmacy | 2909 Mckinney Ave Ste A, Dallas, TX 75204-7479 | 2019-07-30 |
| 1346800604 | Cvs Pharmacy Inc. | Pharmacy | 7979 Belt Line Rd, Dallas, TX 75254-8129 | 2019-06-19 |
| 1073087375 | Medical City Pharmacy LLC | Pharmacy | 3502 Simpson Stuart Rd Ste 300, Dallas, TX 75241-4420 | 2019-01-20 |
| 1538633326 | Methodist Community Pharmacy, LLC | Pharmacy | 1441 N Beckley Ave Lbby B, Dallas, TX 75203-1201 | 2019-01-15 |
| 1700358389 | Titan Specialty Pharmacy | Pharmacy | 8360 Lbj Fwy Ste 215, Dallas, TX 75243-1222 | 2018-12-20 |
| 1932676301 | Nugenerex Ptx1 | Pharmacy | 2301 S Hampton Rd Ste 850, Dallas, TX 75224-1618 | 2018-10-24 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.