Organization
ALBERTSONS LLC
Active
Other names
SAV-ON PHARMACY #0723
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
9831 CAMPO RD, SPRING VALLEY, CA 91977-1418
(619) 461-9170
(619) 461-6735
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
PHY51379
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071PHA382500
—
CA
05
—
071PHA476880
—
CA
01
—
2062387
PK
—
Enumeration date
05/25/2006
Last updated
04/03/2020
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