Organization
ALBERTSONS LLC
Active
Other names
SAV-ON PHARMACY #0757
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
720 3RD AVE, CHULA VISTA, CA 91910-5804
(619) 420-8313
(619) 420-8472
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY51366
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071PHA457810
—
CA
05
—
071PHA476980
—
CA
01
—
2000593
PK
—
Enumeration date
05/26/2006
Last updated
04/03/2020
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