SAFEWAY PHARMACY #1769
NPI 1629014261
Pharmacy - Community/Retail Pharmacy in Stockton, CA

Active since June 21, 2006CLIA 05D1057402 · Waiver
2808 COUNTRY CLUB BLVD, STOCKTON, CA 95204(209) 461-5560(209) 461-5566 Get Directions Write a Review

NPPES record last updated: April 3, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 3, 2020, Oct 17, 2018, Jul 19, 2018 and 1 more (4 updates tracked since 2016).

About Safeway Pharmacy #1769 NPPES

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

SAFEWAY PHARMACY #1769 (NPI 1629014261) is a healthcare organization registered as a community/retail pharmacy in Stockton, California and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through March 16, 2027 and lists Kathy Giannakopoulos, Enrollments Manager, as its authorized official.

NPPES Registry Identity

NPI1629014261
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSAFEWAY INC
Location Address2808 COUNTRY CLUB BLVDStockton, CA 95204-3957
Mailing Address250 E Parkcenter BlvdBoise, ID 83706-3940 · (208) 395-6200 · Fax (623) 336-6896
Fax(209) 461-5566
Organization SubpartNo
Authorized OfficialKathy GiannakopoulosEnrollments Manager · (208) 395-3954
Enumeration DateJune 21, 2006
Last NPPES UpdateApril 3, 20204 updates tracked since enumeration
NPPES CertifiedApril 3, 2020
NPI 1629014261 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 · PHY52307
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
2808 COUNTRY CLUB BLVD, Stockton, CA 95204

Other Names 1

Doing Business AsSafeway Pharmacy #1769

Other Identifiers 2

Other1989859Pk
Medicaid1629014261CA

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 05D1057402

Safeway Pharmacy # 1769 · Stockton, CA
Active · expires Mar 16, 2027
CLIA Number05D1057402
Laboratory TypePharmacy
Certificate Effective DateMarch 17, 2025
Certificate Expiration DateMarch 16, 2027
Laboratory DirectorRonald J. Frazier
Laboratory Phone(209) 461-5560
Laboratory LocationSafeway Pharmacy # 17692808 Country Club Blvd, Stockton, CA 95204
CLIA data matches this NPI record on: Address Name Phone
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 #2707 carries, from the Medicare DMEPOS supplier directory.

Safeway Pharmacy #2707

DMEPOS supplier · Stockton, CAOperated by Safeway Inc

Does not accept Medicare assignment

Safeway Pharmacy #2707 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)20468789
Medicare Participant SinceJanuary 1, 2017
Supplier Location6445 N Pacific AveStockton, CA 95207
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
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
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 7

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

Pharmacist
2808 COUNTRY CLUB BLVD
STOCKTON, CA 95204
Pharmacist
2808 COUNTRY CLUB BLVD
STOCKTON, CA 95204
Pharmacist
2808 COUNTRY CLUB BLVD
STOCKTON, CA 95204
Pharmacist
2808 COUNTRY CLUB BLVD
STOCKTON, CA 95204
Registered Nurse
2808 COUNTRY CLUB BLVD
STOCKTON, CA 95204
Pharmacist
2808 COUNTRY CLUB BLVD
STOCKTON, CA 95204
Pharmacist
2808 COUNTRY CLUB BLVD
STOCKTON, CA 95204

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 1629014261. It was assigned to this organization in the NPPES registry on June 21, 2006. The provider is doing business as Safeway Pharmacy #1769.

Where is Safeway Inc located?

Safeway Inc is located at 2808 Country Club Blvd, Stockton, CA 95204. The listed phone number is (209) 461-5560.

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 #2707 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 05D1057402) is associated with this NPI, valid through March 16, 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 3, 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.