Organization
ALBERTSONS LLC
Active
Other names
Sav-On Pharmacy #3179
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
12475 RANCHO BERNARDO RD, SAN DIEGO, CA 92128-2143
(858) 385-9229
(858) 487-6464
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
54337
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396100285
—
CA
01
—
2157263
PK
—
Enumeration date
12/21/2015
Last updated
04/03/2020
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