Organization
ALBERTSONS LLC
Active
Other names
TOM THUMB PHARMACY #0296
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
6800 VIRGINIA PKWY, MCKINNEY, TX 75071
(972) 542-0010
(972) 542-8018
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
22292
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2098218
PK
—
05
—
465330
—
TX
Enumeration date
06/01/2006
Last updated
04/03/2020
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