Organization
ALBERTSONS LLC
Active
Other names
SAV-ON PHARMACY #0574
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
5755 MAIN ST, SPRINGFIELD, OR 97478-5426
(541) 741-1525
(541) 744-8113
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
RP-0001185
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038948
—
OR
01
—
2078211
PK
—
Enumeration date
05/25/2006
Last updated
04/03/2020
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