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Organization

ALBERTSONS LLC

Active
Other names
SAV ON PHARMACY #1059
Organization subpart
No

Provider details

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

Contact information

Practice address
5500 BOULDER HWY, LAS VEGAS, NV 89122-6010
(702) 435-7339
(702) 352-1082
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
PH02313
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2056729
PK
Enumeration date
05/25/2006
Last updated
04/03/2020
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