Safeway INC
Pharmacy, Community/Retail Pharmacy in Cottage Grove, OR. Organization (NPI-2).
NPI number1215966254
StatusActive
Last updated in NPPESApr 16, 2020
Details
- NPI
- 1215966254
- Entity type
- Organization (NPI-2)
- Legal business name
- Safeway INC
- Organization subpart
- No
- Enumeration date
- Jul 2, 2006
- Certification date
- Apr 16, 2020
- Last updated
- Apr 16, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · DME SUPPLIER - PHARMACY
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 0001336 | OR | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Safeway Pharmacy #1458 (Doing Business As)
Practice location
1500 E Main StCottage Grove, OR 97424-2208
Phone 541-942-7443 · Fax 541-942-7139
Mailing address
250 E Parkcenter BlvdBoise, ID 83706-3940
Authorized official
Kathy Giannakopoulos
Enrollments Manager
2083953954
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