Organization
ALBERTSONS LLC
Active
Organization
ALBERTSONS LLC
Active
Other names
SAVON PHARMACY #0710
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
8920 FLETCHER PKWY, LA MESA, CA 91942-3231
(619) 667-9626
(619) 667-9867
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
PHY51360
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071PHA440640
—
CA
05
—
071PHA477240
—
CA
01
—
1993369
PK
—
Enumeration date
05/25/2006
Last updated
04/03/2020
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