Organization
ALBERTSONS LLC
Active
Other names
SAV-ON PHARMACY #0177
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
4700 N EAGLE RD, BOISE, ID 83713
(208) 939-5149
(208) 939-5282
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
21076RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021724
PK
—
05
—
805558000
—
ID
05
—
807495000
—
ID
Enumeration date
06/02/2006
Last updated
04/02/2020
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