Organization
ACME MARKETS INC
Active
Other names
SAV-ON PHARMACY #3796
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
5300 W BALTIMORE AVE, CLIFTON HEIGHTS, PA 19018-1801
(610) 284-6803
(610) 394-2625
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP415083L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007619290060
—
PA
01
—
2082572
PK
—
Enumeration date
05/30/2006
Last updated
09/12/2019
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