Organization
ALBERTSONS LLC
Active
Organization
ALBERTSONS LLC
Active
Other names
SAVON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAN JOHNSON (MANAGER MANAGED HEALTHCARE)
(208) 395-3436
Entity
Organization
Contact information
Practice address
517 S SEMORAN BLVD, WINTER PARK, FL 32792-4902
(407) 679-5767
(407) 679-2946
Mailing address
3030 CULLERTON ST, FRANKLIN PARK, IL 60131-2205
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6016
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031505200
—
FL
01
—
1006750
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/01/2006
Last updated
11/25/2009
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