Organization
ALBERTSONS LLC
Active
Other names
SAVON PHARMACY #816
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT PROJECTS)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1601 W US HIGHWAY 50, PUEBLO, CO 81008-1690
(719) 543-5921
(719) 543-7740
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
1040000060
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002730
PK
—
05
—
98958267
—
CO
Enumeration date
06/01/2006
Last updated
04/03/2020
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