Organization
ALBERTSONS LLC
Active
Other names
SAV ON PHARMACY #0090
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
7075 W ANN RD, LAS VEGAS, NV 89130-1109
(702) 395-6912
(702) 395-8834
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
PH02359
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124299516
—
NV
01
—
2052281
PK
—
Enumeration date
03/13/2008
Last updated
04/02/2020
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