Organization
ALBERTSONS LLC
Active
Other names
OSCO DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
DIONA TOWNSEND (ASST MGR PLAN IMPLEMENTATION)
(847) 916-4513
Entity
Organization
Contact information
Practice address
4747 E GREENWAY RD, PHOENIX, AZ 85032-4818
(602) 788-6005
(602) 788-6923
Mailing address
3030 CULLERTON ST, FRANKLIN PARK, IL 60131-2205
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y04558
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100522
—
AZ
01
—
1989463
PK
—
Enumeration date
06/07/2006
Last updated
12/10/2013
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