Organization
ALBERTSONS LLC
Active
Other names
SAV-ON PHARMACY #0552
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMANT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
27702 CROWN VALLEY PKWY, SUITE B, LADERA RANCH, CA 92694-0608
(949) 364-2098
(949) 364-2198
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
PHY51296
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071PHA483980
—
CA
01
—
2112412
PK
—
Enumeration date
05/11/2007
Last updated
04/03/2020
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