Albertsons LLC
Organization Active NPI Community/Retail Pharmacy · Battle Ground, WA
NPI 1023064532 · NPPES record last updated May 10, 2021
Key facts
- NPI
- 1023064532
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHAR.CF.60342369 (WA)
- Legal business name
- ALBERTSONS LLC
- Practice address
- 2108 W Main St
Battle Ground, WA 98604-9143 - Phone
- (360) 687-4092
- Fax
- (360) 687-4091
- NPI assigned
- May 26, 2006
- Reactivated
- May 10, 2021
- Organization subpart
- No
Authorized official
- Name
- Kathy Giannakopoulos
- Title
- Enrollment Manager
- Phone
- (208) 395-3954
Corporate family (same tax ID) 13
Member of 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130809000170 | WA | DME Supplier - Pharmacy |
8729983515 | Practice locations: Battle Ground, WA |
National Provider Directory
- Tax ID family
- Albertsons 851
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHAR.CF.60342369 | WA | Yes |
Addresses
Primary practice location
2108 W Main St
Battle Ground, WA 98604-9143
Mailing address
250 E Parkcenter Blvd
Boise, ID 83706-3940
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6022552 | Medicaid | WA | |
| 2110554 | Other | PK |
Other names
- SAV-ON PHARMACY #2592
Other providers in Battle Ground, WA
- David Abrahamson
- Jessica Michelle Adams
- Stefanie Leigh Adams
- Ahr Battle Ground Wa Alf TRS Sub, LLC
- Dennis Everett Alberson
- Alexandra Demetro, ND
- Aligned for Health and Wellness, LLC
- David J Allen
- Anchor Point Counseling Center
- Emily Anderson
All providers in Battle Ground, WA · Community/Retail Pharmacy in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.