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Organization

ALBERTSONS LLC

Active
Other names
SAV-ON PHARMACY #2994
Organization subpart
No

Provider details

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

Contact information

Practice address
5630 N DESERT BLVD, EL PASO, TX 79912-1636
(915) 845-1422
(915) 845-1611
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
20676
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2095197
PK
05
464766
TX
Enumeration date
06/01/2006
Last updated
04/03/2020
About Stedi
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  • Eligibility checks
  • EDI platform