Organization
ALBERTSONS LLC
Active
Other names
SAFEWAY PHARMACY #0804
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1451 W EISENHOWER BLVD, LOVELAND, CO 80537-3110
(970) 667-5642
(970) 203-1730
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
PDO.0820000080
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002184
PK
—
05
—
64571840
—
CO
Enumeration date
06/01/2006
Last updated
04/03/2020
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