Organization
ALBERTSONS LLC
Active
Other names
Albertsons Pharmacy #3435
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1005 W COULTER AVE, POWELL, WY 82435-2530
(307) 271-3160
(307) 271-3161
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
02/13/2023
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