Organization
ALBERTSONS LLC
Active
Other names
Albertsons Pharmacy #3203
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1350 N SILVERBELL RD, TUCSON, AZ 85745-2228
(520) 622-2979
(520) 623-3942
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-6200
(623) 336-6896
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y006762
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122659
—
AZ
01
—
2157265
PK
—
Enumeration date
12/21/2015
Last updated
08/17/2022
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