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Organization
ALBERTSONS LLC
Active
Organization
ALBERTSONS LLC
Active
Other names
Albertsons Pharmacy #1311
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY GREEN (ENROLLMENT MANAGER)
(208) 395-3932
Entity
Organization
Contact information
Practice address
7515 PERKINS RD, BATON ROUGE, LA 70808-4330
(225) 769-6084
(225) 767-7300
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
PHY.001625-RC
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1253308
—
LA
01
—
2030998
PK
—
Enumeration date
06/01/2006
Last updated
06/18/2025
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