# ALBERTSONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SAV-ON PHARMACY \#1329
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407803869
- **Authorized official:** KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
- **Authorized official phone:** (208) 395-3954

## Contact information

- **Practice address:** 745 N DIXIE DOWNS DR, ST GEORGE, UT 84770
- **Practice address phone:** (435) 688-7196
- **Practice address fax:** (435) 688-7538
- **Mailing address:** 250 E PARKCENTER BLVD, BOISE, ID 83706-3940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 8600191-1703 | UT | Yes |

## Other

- **Enumeration date:** 05/30/2006
- **Last updated:** 04/03/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 204057706002 | — | UT |
| 01 | — | 2101158 | PK | — |