SAFEWAY PHARMACY #0535 – Community/Retail Pharmacy, NPI 1790721397

SAFEWAY PHARMACY #0535 is a healthcare provider. based in Boise, Idaho. specializing in Community/Retail Pharmacy. The organization holds a License No. PHAR.CF.60515643 (WA). The NPI Number for SAFEWAY PHARMACY #0535 is 1790721397

Main info

Organization
Name
SAFEWAY PHARMACY #0535
NPI
1790721397
Phone
Not provided
Address
250 E PARKCENTER BLVD
Authorized Official
KATHY GIANNAKOPOULOS ENROLLMENTS MANAGER
Enumeration Date
21 June 2006
Last Update Date
16 April 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for SAFEWAY PHARMACY #0535

  • 250, East Parkcenter Boulevard, Boise, Ada County, Idaho, 83706, United States

    BOISE, ID 837063940

    Phone:

    Type: Mailing

  • Bothell Way Northeast, Bothell, King County, Washington, 98011, United States

    BOTHELL, WA 980127139

    Phone: (425) 486-4473

    Fax: (425) 485-0725

    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: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-04-30 (771 days ago).

Enrollment records

1

Earliest due date

2024-04-30

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
O20100930050960OPharmacyWA2024-04-30

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

How do I look up SAFEWAY PHARMACY #0535 by NPI?
Use NPI 1790721397 when you need to reference SAFEWAY PHARMACY #0535 in forms, claims, or directories.
Is SAFEWAY PHARMACY #0535 active in the national directory?
SAFEWAY PHARMACY #0535's public NPI profile is in an active state.
What does SAFEWAY PHARMACY #0535 treat or focus on?
Patients typically see SAFEWAY PHARMACY #0535 under the specialty Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Does SAFEWAY PHARMACY #0535 practice in Idaho?
You will see Boise, Idaho on file for SAFEWAY PHARMACY #0535 alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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