NPIMap

Organization Active NPI

Albertsons LLC

  • Community/Retail Pharmacy
  • Phoenix, AZ
National Provider Identifier
1316986797
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
Y04596 Issued in AZ
Legal business name
ALBERTSONS LLC
Doing business as
OSCO PHARMACY
Practice address
1849 W Greenway Rd
Phoenix, AZ 85023-3474
Phone
(602) 866-0647
Fax
(602) 866-0674
NPI assigned
Jun 4, 2006
Organization subpart
Yes
Parent organization
ALBERTSONS HOLDINGS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Y04596 AZ Primary

Addresses

Primary practice location

1849 W Greenway Rd
Phoenix, AZ 85023-3474

Mailing address

1849 W Greenway Rd
Phoenix, AZ 85023-3474

Other identifiers 2

IdentifierTypeStateIssuer
0319928OtherOTHER ID NUMBER-COMMERCIAL NUMBER
099598MedicaidAZ

Other names 1

  • OSCO PHARMACY 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

1849 W Greenway Rd
Phoenix, AZ 85023
Phone (602) 866-0647

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": "1197417600000",
    "number": "1316986797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 W GREENWAY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850233474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 W GREENWAY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850233474",
            "telephone_number": "602-866-0647",
            "fax_number": "602-866-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERTSONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALBERTSONS HOLDINGS LLC",
        "enumeration_date": "2006-06-04",
        "last_updated": "2007-12-12",
        "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",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "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": "Y04596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0319928",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099598",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSCO PHARMACY",
            "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 Dec 12, 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.