Safeway INC
Pharmacy, Community/Retail Pharmacy in Stockton, CA. Organization (NPI-2).
Details
- NPI
- 1629014261
- Entity type
- Organization (NPI-2)
- Legal business name
- Safeway INC
- Organization subpart
- No
- Enumeration date
- Jun 21, 2006
- Certification date
- Apr 3, 2020
- Last updated
- Apr 3, 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 | PHY52307 | CA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 333600000X | Pharmacy | – | – |
Other names
- Safeway Pharmacy #1769 (Doing Business As)
Practice location
2808 Country Club BlvdStockton, CA 95204-3957
Phone 209-461-5560 · Fax 209-461-5566
Mailing address
250 E Parkcenter BlvdBoise, ID 83706-3940
Phone 208-395-6200 · Fax 623-336-6896
Authorized official
Kathy Giannakopoulos
Enrollments Manager
2083953954
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 49 Community/Retail Pharmacy providers in Stockton · All 11,041 providers in Stockton
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