Organization
ALBERTSONS LLC
Active
Other names
OSCO DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZO TORRES (NEW STORE ENROLLMENTS)
(847) 916-4463
Entity
Organization
Contact information
Practice address
4240 W BELL RD, GLENDALE, AZ 85308-4030
(602) 548-4527
(602) 548-6275
Mailing address
4240 W BELL RD, GLENDALE, AZ 85308-4030
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y04595
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0313546
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
099606
—
AZ
Enumeration date
06/01/2006
Last updated
11/21/2007
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