Organization
ALBERTSONS LLC
Active
Other names
Albertsons Pharmacy #0131
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1410 WESTPARK PLZ, ONTARIO, OR 97914-2000
(541) 889-9125
(541) 889-9126
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/27/2022
Last updated
05/30/2022
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