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Organization

ALBERTSONS LLC

Active
Other names
Osco Drug #2985
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization

Contact information

Practice address
18411 N CAVE CREEK RD, PHOENIX, AZ 85032-1099
(602) 494-7424
(602) 494-7520
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
Y04584
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
099770
AZ
01
1990034
PK
Enumeration date
06/02/2006
Last updated
04/03/2020
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