Organization
ALBERTSONS LLC
Active
Other names
SAV ON PHARMACY #0061
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
4850 W CRAIG RD, LAS VEGAS, NV 89130-2727
(702) 515-1466
(702) 515-1469
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
PH01604
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2051524
PK
—
05
—
2802408
—
NV
Enumeration date
05/25/2006
Last updated
04/01/2020
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