Organization
ALBERTSONS LLC
Active
Other names
Sav-On Pharmacy #4009
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
8410 FARM RD, LAS VEGAS, NV 89131-8158
(702) 658-6669
(702) 658-7987
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
PH01655
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2051586
PK
—
05
—
2802186
—
NV
Enumeration date
05/25/2006
Last updated
04/06/2020
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