Organization
ALBERTSONS LLC
Active
Other names
SAV-ON PHARMACY #0160
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
10500 W OVERLAND RD, BOISE, ID 83709
(208) 376-1382
(208) 378-5805
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
21068RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002257700
—
ID
01
—
2020645
PK
—
05
—
807495200
—
ID
Enumeration date
05/26/2006
Last updated
04/02/2020
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