Organization
ALBERTSONS LLC
Active
Other names
Sav-On Pharmacy #2804, SAV-ON PHARMACY #2804
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
7975 BLUE DIAMOND RD, LAS VEGAS, NV 89178
(702) 614-4331
(702) 614-4322
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH03708
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167826
PK
—
Enumeration date
02/13/2017
Last updated
10/04/2018
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