# ALBERTSONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Albertsons Pharmacy \#1311
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962449413
- **Authorized official:** TAMMY GREEN (ENROLLMENT MANAGER)
- **Authorized official phone:** (208) 395-3932

## Contact information

- **Practice address:** 7515 PERKINS RD, BATON ROUGE, LA 70808-4330
- **Practice address phone:** (225) 769-6084
- **Practice address fax:** (225) 767-7300
- **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 | PHY.001625-RC | LA | Yes |

## Other

- **Enumeration date:** 06/01/2006
- **Last updated:** 06/18/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1253308 | — | LA |
| 01 | — | 2030998 | PK | — |