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Organization

ALBERTSONS LLC

Active
Other names
SAVON PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
SUNNY YOST (ASST MGR, THIRD PARTY IMPLEMENTATIO)
(208) 395-3920
Entity
Organization

Contact information

Practice address
2170 GULF TO BAY BLVD, CLEARWATER, FL 33765-3918
(727) 441-8482
(727) 461-4386
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
5012
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
031435800
FL
01
2008795
PK
Enumeration date
06/01/2006
Last updated
01/08/2016
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