NPI 1457880940 · live from the CMS NPI Registry
Albertsons LLC
Dietitian, Registered in Boise, ID. National Provider Identifier 1457880940, active.
NPI record
| NPI | 1457880940 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1219 S Broadway Ave, Boise, ID 83706 |
| Practice phone | 208-433-9905 |
| Mailing address | 250 E Parkcenter Blvd, Boise, ID 83706 |
| Enumerated | June 8, 2017 |
| Last updated | August 10, 2018 |
| Authorized official | Tiffany Eliopulos, Asst Mgr, Pharmacy Enrollments |
| Other names | Albertsons Pharmacy; Sav-On Pharmacy |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — |
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.