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Organization

ALBERTSONS LLC

Active
Other names
Albertsons Pharmacy #3195
Organization subpart
No

Provider details

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

Contact information

Practice address
3499 E FAIRVIEW AVE, MERIDIAN, ID 83642-5848
(208) 395-3906
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3999

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
07/23/2018
Last updated
04/03/2020
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