# ALBERTSONS LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Safeway Pharmacy \#0591
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427004423
- **Authorized official:** KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
- **Authorized official phone:** (208) 395-3954

## Contact information

- **Practice address:** 888 NE 25TH AVE, HILLSBORO, OR 97124-5975
- **Practice address phone:** (503) 681-8640
- **Practice address fax:** (503) 648-2255
- **Mailing address:** 250 E PARKCENTER BLVD, BOISE, ID 83706-3940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | RP-0001911 | OR | Yes |

## Other

- **Enumeration date:** 05/25/2006
- **Last updated:** 05/16/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2079190 | PK | — |
| 05 | — | 228838 | — | OR |