SAFEWAY PHARMACY #1747 (SAFEWAY INC) NPI 1457380404

Pharmacy (Community/Retail Pharmacy) in Chino Valley, AZ

NPI 1457380404 Organization Pharmacy Community/Retail Pharmacy Medicare Supplier Does Not Accept Medicare Approved Payment CLIA Number 03D2073046 CLIA Certificate of Waiver

About SAFEWAY PHARMACY #1747 (SAFEWAY INC)

Safeway Pharmacy #1747 (safeway Inc) is a provider established in Chino Valley, Arizona specializing in pharmacy (community/retail pharmacy) . The NPI number of Safeway Pharmacy #1747 (safeway Inc) is 1457380404 and was assigned on July 2006. The practitioner's primary taxonomy code is 3336C0003X with license number Y006173 (AZ). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Safeway Pharmacy #1747. The authorized official of this NPI record is Kathy Giannakopoulos (Enrollments Manager)

Safeway Pharmacy #1747 is a medicare supplier with PTAN 0237520317 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Blood Glucose Monitors/Supplies (Non-Mail Order) or Orthoses: Off-The-Shelf or Urological Supplies or Surgical Dressings or Epoetin or Infusion Drugs or Diabetic Shoes and Inserts or Immunosuppressive Drugs or Ostomy Supplies.

The CLIA number of Safeway Pharmacy #1747 is 03D2073046 registered as a "pharmacy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Safeway Pharmacy #1747 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1457380404

Provider NameSAFEWAY PHARMACY #1747 (SAFEWAY INC)
Provider Location Address1031 N HIGHWAY 89 CHINO VALLEY, AZ 86323
Provider Mailing Address250 E PARKCENTER BLVD BOISE, ID 83706
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameSAFEWAY PHARMACY #1747
Other Name TypeDoing Business As (3)
Enumeration Date07-02-2006
Last Update Date04-06-2020


Primary Taxonomy

Taxonomy Code3336C0003X
ClassificationPharmacy
TypeSuppliers
SpecializationCommunity/Retail Pharmacy
License No.Y006173
License StateAZ
Taxonomy DescriptionA 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.

Business Address

SAFEWAY PHARMACY #1747
1031 N HIGHWAY 89
CHINO VALLEY, AZ
ZIP 86323
Phone: (928) 636-8425
Fax: (928) 636-8470

Get Directions


Mailing Address

SAFEWAY PHARMACY #1747
250 E PARKCENTER BLVD
BOISE, ID
ZIP 83706
Phone: (208) 395-6200
Fax: (623) 336-6896



Authorized Official

Authorized Official Name KATHY GIANNAKOPOULOS
Authorized Official TitleENROLLMENTS MANAGER
Authorized Official Phone(208) 395-3954

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN0237520317
Accepts Medicare AssignmentNO
Specialities ListGrocery Store, Pharmacy.
Supplies List
  • 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
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
  • Urological Supplies - Catheters, Urinary collection devices
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
  • Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
  • Infusion Drugs -
  • Diabetic Shoes and Inserts - Shoes, Socks, Insoles
  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
Competitive BiddingNO

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1457380404 is:

CLIA Number03D2073046
Facility TypePHARMACY
Certificate TypeCertificate of Waiver

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1332B00000XSuppliersDurable Medical Equipment & Medical SuppliesNo

Taxonomy Description: a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
077702MEDICAID (05)AZ
1989398OTHER (01)

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1790388999 RUSELLE JANINA FIDER ARAGON RPH
Individual
Pharmacist1031 N HIGHWAY 89
CHINO VALLEY, AZ 86323
(928) 636-8425

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.