Provider Demographics
NPI:1952865248
Name:SAFEWAY HOME CARE
Entity Type:Organization
Organization Name:SAFEWAY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABDULRAHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-756-4110
Mailing Address - Street 1:30 SCHOONER LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2840
Mailing Address - Country:US
Mailing Address - Phone:207-756-4110
Mailing Address - Fax:
Practice Address - Street 1:236 OXFORD ST STE 12
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3029
Practice Address - Country:US
Practice Address - Phone:207-774-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care