NPI 1669428215 · live from the CMS NPI Registry
Albertsons LLC
Pharmacy, Community/Retail Pharmacy in Troutdale, OR. National Provider Identifier 1669428215, active.
NPI record
| NPI | 1669428215 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 25691 Se Stark St, Troutdale, OR 97060 |
| Practice phone | 503-667-9003 |
| Mailing address | 250 E Parkcenter Blvd, Boise, ID 83706 |
| Enumerated | May 25, 2006 |
| Last updated | January 20, 2023 |
| Authorized official | Kathy Giannakopoulos, Enrollment Manager |
| Other names | Safeway Pharmacy #0536 |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | — |
| Pharmacy | 333600000X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | RP-0001883 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.