SAFEWAY PHARMACY #1109
NPI 1356370365
Pharmacy - Community/Retail Pharmacy in Vacaville, CA

Active since July 02, 2006CLIA 05D2057735 · Waiver
2090 HARBISON DR, VACAVILLE, CA 95687(707) 452-7279(707) 452-7282 Get Directions Write a Review

NPPES record last updated: April 21, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 21, 2020, Oct 17, 2018, Jul 19, 2018 and 1 more (4 updates tracked since 2016).

About Safeway Pharmacy #1109 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAFEWAY PHARMACY #1109 (NPI 1356370365) is a healthcare organization registered as a community/retail pharmacy in Vacaville, California and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through April 22, 2027 and lists Kathy Giannakopoulos, Enrollments Manager, as its authorized official.

NPPES Registry Identity

NPI1356370365
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSAFEWAY INC
Location Address2090 HARBISON DRVacaville, CA 95687-3902
Mailing Address250 E Parkcenter BlvdBoise, ID 83706-3940 · (208) 395-6200 · Fax (623) 336-6896
Fax(707) 452-7282
Organization SubpartNo
Authorized OfficialKathy GiannakopoulosEnrollments Manager · (208) 395-3954
Enumeration DateJuly 2, 2006
Last NPPES UpdateApril 21, 20204 updates tracked since enumeration
NPPES CertifiedApril 21, 2020
NPI 1356370365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in CA · PHY52235
Definition
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
2090 HARBISON DR, Vacaville, CA 95687

Other Names 1

Doing Business AsSafeway Pharmacy #1109

Other Identifiers 2

Medicaid1356370365CA
Other2034706Pk

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2057735

Safeway Pharmacy # 1109 · Vacaville, CA
Active · expires Apr 22, 2027
CLIA Number05D2057735
Laboratory TypePharmacy
Certificate Effective DateApril 23, 2025
Certificate Expiration DateApril 22, 2027
Laboratory DirectorKira Eastman
Laboratory Phone(925) 452-7279
Laboratory LocationSafeway Pharmacy # 11092090 Harbison Drive, Vacaville, CA 95687
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Safeway Pharmacy #1109 carries, from the Medicare DMEPOS supplier directory.

Safeway Pharmacy #1109

DMEPOS supplier · Vacaville, CAOperated by Safeway Inc

Does not accept Medicare assignment

Safeway Pharmacy #1109 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20467985
Medicare Participant SinceJanuary 1, 2017
Supplier Location2090 Harbison DrVacaville, CA 95687
Supplier Specialties
Pharmacy Grocery Store

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
2090 HARBISON DR
VACAVILLE, CA 95687
Pharmacist
2090 HARBISON DR
VACAVILLE, CA 95687
Pharmacist
2090 HARBISON DR
VACAVILLE, CA 95687
Pharmacist
2090 HARBISON DR
VACAVILLE, CA 95687

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Safeway Inc's NPI number?

The NPI number for Safeway Inc is 1356370365. It was assigned to this organization in the NPPES registry on July 2, 2006. The provider is doing business as Safeway Pharmacy #1109.

Where is Safeway Inc located?

Safeway Inc is located at 2090 Harbison Dr, Vacaville, CA 95687. The listed phone number is (707) 452-7279.

What is Safeway Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Safeway Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Safeway Pharmacy #1109 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Safeway Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2057735) is associated with this NPI, valid through April 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Safeway Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Arizona Complete Health and Ambetter from Arkansas Health & Wellness and 41 other insurers list Safeway Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Safeway Inc was last updated on April 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.