Organization
ACME MARKETS INC
Active
Other names
SAV-ON PHARMACY #1770
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
503 MACDADE BLVD, HOLMES, PA 19043
(610) 586-2096
(610) 586-5889
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
PP481088
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007619290068
—
PA
01
—
2085862
PK
—
Enumeration date
05/25/2006
Last updated
09/12/2019
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