Organization
ALBERTSONS LLC
Active
Other names
SAVON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZO TORRES (SR DEPT SPECIALIST)
(847) 916-4463
Entity
Organization
Contact information
Practice address
2755 77TH AVE SE, MERCER ISLAND, WA 98040-2811
(206) 232-2222
(206) 232-6485
Mailing address
250 E PARKCENTER BLVD, QUARRY B BLDG, BOISE, ID 83706-3940
(208) 395-3436
(208) 495-4503
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60342578
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110622
PK
—
05
—
6022727
—
WA
Enumeration date
05/25/2006
Last updated
05/07/2015
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