NPI 1205036134 · live from the CMS NPI Registry
Albertsons LLC
Pharmacy, Community/Retail Pharmacy in Las Vegas, NV. National Provider Identifier 1205036134, active.
NPI record
| NPI | 1205036134 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 11720 W Charleston Blvd, Las Vegas, NV 89135 |
| Practice phone | 702-363-3306 |
| Mailing address | 250 E Parkcenter Blvd, Boise, ID 83706 |
| Enumerated | July 19, 2007 |
| Last updated | April 3, 2020 |
| Authorized official | Kathy Giannakopoulos, Enrollment Manager |
| Other names | Sav-On Pharmacy #0460 |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | PH02289 (NV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.