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
1825 17TH ST, CODY, WY 82414
(307) 527-7426
(307) 527-7435
Mailing address
1825 17TH ST, CODY, WY 82414
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5203219
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5203219
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/04/2006
Last updated
11/21/2007
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