Organization
ALBERTSONS LLC
Active
Other names
SAVON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZO TORRES (NEW STORE ENROLLMENTS)
(847) 916-4463
Entity
Organization
Contact information
Practice address
2205 LONGMIRE DR, COLLEGE STATION, TX 77845-5230
(979) 764-3977
(979) 764-0968
Mailing address
2205 LONGMIRE DR, COLLEGE STATION, TX 77845-5230
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
14585
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4584036
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
463347
—
TX
Enumeration date
06/01/2006
Last updated
11/21/2007
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