Organization
ALBERTSONS LLC
Active
Other names
SAVON PHARMACY #897
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
2512 BROADWAY, GRAND JUNCTION, CO 81507-2758
(970) 257-0233
(970) 257-7802
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
PDO.0530000055
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003400
PK
—
05
—
55429033
—
CO
Enumeration date
06/01/2006
Last updated
04/03/2020
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