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Organization

ALBERTSONS LLC

Active
Other names
Sav-On Pharmacy #0140
Organization subpart
No

Provider details

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

Contact information

Practice address
7676 FIRESTONE BLVD, DOWNEY, CA 90241
(562) 869-9655
(562) 869-9695
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
PHY51326
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
071PHA513260
CA
01
2065061
PK
Enumeration date
05/25/2006
Last updated
04/02/2020
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