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Organization

ALBERTSONS LLC

Active
Other names
SAFEWAY PHARMACY #2812
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization

Contact information

Practice address
910 W CHERRY ST, LOUISVILLE, CO 80027-3044
(303) 673-0697
(303) 666-4696
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
810000006
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2002674
PK
05
49577042
CO
Enumeration date
06/01/2006
Last updated
04/03/2020
About Stedi
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