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Organization
ALBERTSONS LLC
Active
Organization
ALBERTSONS LLC
Active
Other names
Albertsons Pharmacy #0218
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
105 SOUTHFIELD RD, SHREVEPORT, LA 71105
(318) 861-2431
(318) 861-4445
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
1018
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1238961
—
LA
01
—
2035156
PK
—
Enumeration date
06/02/2006
Last updated
06/17/2025
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