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Organization
ALBERTSONS LLC
Active
Organization
ALBERTSONS LLC
Active
Other names
SAV-ON PHARMACY #0301
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
915 W RED CLIFFS DR, WASHINGTON, UT 84780
(435) 628-7430
(435) 688-8171
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
8600154-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204057706009
—
UT
01
—
2100236
PK
—
Enumeration date
05/26/2006
Last updated
04/03/2020
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