SAFEWAY PHARMACY #0402 – Community/Retail Pharmacy, NPI 1467844530

SAFEWAY PHARMACY #0402 is a healthcare provider. based in Boise, Idaho. specializing in Community/Retail Pharmacy. The organization holds a License No. CF60543575 (WA). The NPI Number for SAFEWAY PHARMACY #0402 is 1467844530

Main info

Organization
Name
SAFEWAY PHARMACY #0402
NPI
1467844530
Phone
(208) 395-3963
Address
250 E PARKCENTER BLVD
Authorized Official
KATHY GIANNAKOPOULOS ENROLLMENTS MANAGER
Enumeration Date
26 February 2015
Last Update Date
12 March 2020
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness80
Years active:11State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for SAFEWAY PHARMACY #0402

  • 250 E PARKCENTER BLVD

    BOISE, ID 837063940

    Phone: (208) 395-3963

    Fax: (623) 336-6896

    Type: Mailing

  • 1450 SW ERIE ST

    OAK HARBOR, WA 982773104

    Phone: (360) 240-1063

    Fax: (360) 240-0623

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-08-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (587 days ago).

Enrollment records

1

Earliest due date

2024-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20150821014434OPharmacyWA2024-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83706)

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Reviews

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Frequently asked questions

Is SAFEWAY PHARMACY #0402 listed with a National Provider Identifier?
Yes — SAFEWAY PHARMACY #0402 has NPI 1467844530 on file in the registry.
Is SAFEWAY PHARMACY #0402 shown as active in public data?
Registry records indicate SAFEWAY PHARMACY #0402 maintains an active NPI.
What expertise is attributed to SAFEWAY PHARMACY #0402?
SAFEWAY PHARMACY #0402's specialty line reads Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
What locale is associated with SAFEWAY PHARMACY #0402?
Directory geography for SAFEWAY PHARMACY #0402 centers on Boise, Idaho.
When was this NPI issued?
Enumeration for SAFEWAY PHARMACY #0402 is noted as February 26, 2015 where the registry provides it.

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