| Organization Name: | SAFEWAY PHARMACY |
| NPI Number: | 1437275518 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VIVIAN SUE DIVELBISS (PHARMACY TECH) |
| Mailing Address: | 450 White Spar Rd Prescott |
| State: | AZ US |
| Postal Code: | 863034626 |
| Phone Number: | 9287783098 |
| Fax Number: | |
| NPI Enumeration Date: | 03/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 183700000X |
| License Number: | 3306 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacy Technician |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |