NPIMap

Organization Active NPI

Albertsons LLC

  • Community/Retail Pharmacy
  • Phoenix, AZ
National Provider Identifier
1235178617
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
Y04553 Issued in AZ
Legal business name
ALBERTSONS LLC
Doing business as
OSCO DRUG
Practice address
4820 E Ray Rd
Phoenix, AZ 85044-6402
Phone
(480) 893-1974
Fax
(480) 592-9276
NPI assigned
Jun 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lorenzo Torres
Title
New Store Enrollments
Phone
(847) 916-4463

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Y04553 AZ Primary

Addresses

Primary practice location

4820 E Ray Rd
Phoenix, AZ 85044-6402

Mailing address

4820 E Ray Rd
Phoenix, AZ 85044-6402

Other identifiers 3

IdentifierTypeStateIssuer
0318673OtherOTHER ID NUMBER-COMMERCIAL NUMBER
0318673OtherOTHER ID NUMBER
100621MedicaidAZ

Other names 1

  • OSCO DRUG Doing business as

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4820 E Ray Rd
Phoenix, AZ 85044
Phone (480) 893-1974

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1235178617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 E RAY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 E RAY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446402",
            "telephone_number": "480-893-1974",
            "fax_number": "480-592-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERTSONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "LORENZO",
        "authorized_official_title_or_position": "NEW STORE ENROLLMENTS",
        "authorized_official_telephone_number": "847-916-4463"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y04553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0318673",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "0318673",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100621",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSCO DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.