Organization
ALBERTSONS LLC
Active
Other names
OSCO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZO TORRES (NEW STORE ENROLLMENTS)
(847) 916-4463
Entity
Organization
Contact information
Practice address
855 OMAHA ST, RAPID CITY, SD 57701-2655
(605) 343-8542
(605) 341-9367
Mailing address
855 OMAHA ST, RAPID CITY, SD 57701-2655
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
96
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4303626
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8502520
—
SD
Enumeration date
06/02/2006
Last updated
11/21/2007
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