Organization
ALBERTSONS LLC
Active
Organization
ALBERTSONS LLC
Active
Other names
ALBERTSONS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DIONA TOWNSEND (ASST MGR PLAN IMPLEMENTATION)
(847) 916-4513
Entity
Organization
Contact information
Practice address
3450 HIGHWAY 190, SUITE 8, MANDEVILLE, LA 70471-3196
(985) 626-0481
(985) 626-5452
Mailing address
3030 CULLERTON ST, FRANKLIN PARK, IL 60131-2205
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.006155-RC
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235199
—
LA
01
—
2120875
PK
—
Enumeration date
07/01/2009
Last updated
10/11/2014
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