Active NPI
Albertsons LLC
- Community/Retail Pharmacy
- Canyon Country, CA
National Provider Identifier
1114973773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY51322
- Legal business name
- ALBERTSONS LLC
- Practice address
- 18571 Soledad Cyn
Canyon Country, CA 91351-3700 - Phone
- (661) 298-0233
- Fax
- (661) 298-4912
- NPI assigned
- May 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Diona Townsend
- Title
- Asst Manager Plan Implementation
- Phone
- (847) 916-4513
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY51322 | CA | Primary |
Addresses
Primary practice location
18571 Soledad Cyn
Canyon Country, CA 91351-3700
Mailing address
250 E Parkcenter Blvd
Quarry B BLDG
Boise, ID 83706-3940
Phone (208) 395-3436
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 071PHA389610 | Medicaid | CA | |
| 2062471 | Other | PK | |
| 071PHA476840 | Medicaid | CA |
Other names 1
- SAVON PHARMACY
National Provider Directory
National Provider DirectoryMember of 7
Organizations this organization is a member of, according to the National Provider Directory.
Locations
18571 Soledad Cyn
Canyon Country, CA 91351
Phone (661) 298-0233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1374192000000",
"number": "1114973773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 E PARKCENTER BLVD",
"address_2": "QUARRY B BLDG",
"city": "BOISE",
"state": "ID",
"postal_code": "837063940",
"telephone_number": "208-395-3436",
"fax_number": "208-495-4503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18571 SOLEDAD CYN",
"city": "CANYON COUNTRY",
"state": "CA",
"postal_code": "913513700",
"telephone_number": "661-298-0233",
"fax_number": "661-298-4912"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALBERTSONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-25",
"last_updated": "2013-07-19",
"status": "A",
"authorized_official_last_name": "TOWNSEND",
"authorized_official_first_name": "DIONA",
"authorized_official_title_or_position": "ASST MANAGER PLAN IMPLEMENTATION",
"authorized_official_telephone_number": "847-916-4513"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "PHY51322",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "071PHA389610",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2062471",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "071PHA476840",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SAVON PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Canyon Country, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.