Organization
ALBERTSONS LLC
Active
Other names
SAV-ON PHARMACY #0745
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
655 14TH ST, SAN DIEGO, CA 92101-7584
(619) 237-9127
(619) 237-9144
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY51376
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071PHA482560
—
CA
01
—
2115285
PK
—
Enumeration date
10/11/2006
Last updated
04/03/2020
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