Provider Demographics
NPI:1295473387
Name:SAFEWAY ENTERPRISES
Entity type:Organization
Organization Name:SAFEWAY ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:GOLATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-749-0504
Mailing Address - Street 1:7003 GLOBAL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-1977
Mailing Address - Country:US
Mailing Address - Phone:502-749-0504
Mailing Address - Fax:
Practice Address - Street 1:7003 GLOBAL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-1977
Practice Address - Country:US
Practice Address - Phone:502-749-0504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service