Organization
ALBERTSONS LLC
Active
Other names
SAV-ON PHARMACY #0130
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
911 N MAIN ST, HAILEY, ID 83333
(208) 788-6713
(208) 788-6716
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
21050RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021863
PK
—
05
—
806287100
—
ID
05
—
807496100
—
ID
Enumeration date
05/26/2006
Last updated
04/02/2020
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