Organization
ALBERTSONS LLC
Active
Other names
SAV-ON PHARMACY #0332
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
4800 BLUE DIAMOND RD, LAS VEGAS, NV 89139
(702) 260-4594
(702) 260-6603
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
PH02358
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487820973
—
NV
01
—
2052293
PK
—
Enumeration date
05/05/2008
Last updated
04/03/2020
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