NPI 1124473954 · live from the CMS NPI Registry
Albertsons LLC
Pharmacy, Community/Retail Pharmacy in Grants Pass, OR. National Provider Identifier 1124473954, active.
NPI record
| NPI | 1124473954 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 1690 Sw Allen Creek Rd, Grants Pass, OR 97527 |
| Practice phone | 541-471-7085 |
| Mailing address | 250 E Parkcenter Blvd, Boise, ID 83706 |
| Enumerated | April 29, 2016 |
| Last updated | April 3, 2020 |
| Authorized official | Kathy Giannakopoulos, Enrollment Manager |
| Other names | Sav-On Pharmacy #3541 |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | RP-0002020 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.