Organization
ALBERTSONS LLC
Active
Other names
Sav-On Pharmacy #3411
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
8611 STEILACOOM BLVD SW, LAKEWOOD, WA 98498-4716
(253) 582-0648
(253) 582-8664
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
PHAR.CF.60660190
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2062862
—
WA
01
—
2160034
PK
—
Enumeration date
04/29/2016
Last updated
04/03/2020
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