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Organization

ALBERTSONS LLC

Active
Other names
Sav-On Pharmacy #3206
Organization subpart
No

Provider details

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

Contact information

Practice address
190 N BOULDER HWY, HENDERSON, NV 89015-5308
(702) 565-7805
(702) 565-1305
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
PH03518
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568828655
NV
01
2157375
PK
Enumeration date
01/06/2016
Last updated
04/03/2020
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