Organization
ALBERTSONS LLC
Active
Other names
SAV-ON PHARMACY #0460
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
11720 W CHARLESTON BLVD, LAS VEGAS, NV 89135
(702) 363-3306
(702) 363-3619
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
PH02289
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100512930
—
NV
01
—
2052245
PK
—
Enumeration date
07/19/2007
Last updated
04/03/2020
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