Albertsons LLC
Organization Active NPI Community/Retail Pharmacy · Springfield, OR
NPI 1366498362 · NPPES record last updated Apr 3, 2020
Key facts
- NPI
- 1366498362
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- RP-0001089 (OR)
- Legal business name
- ALBERTSONS LLC
- Practice address
- 2000 Marcola Rd
Springfield, OR 97477-2562 - Phone
- (541) 746-9424
- Fax
- (541) 744-8110
- NPI assigned
- May 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Kathy Giannakopoulos
- Title
- Enrollment Manager
- Phone
- (208) 395-3954
Corporate family (same tax ID) 16
Member of 7
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D1080540 | Sav-on Pharmacy #0570 | Certificate of waiver | Dec 27, 2026 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Sav-on Pharmacy #0570 |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Surgical Dressings | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130730000091 | OR | DME Supplier - Pharmacy |
8729983515 | Practice locations: Springfield, OR |
National Provider Directory
- Tax ID family
- Albertsons 851
Locations
2000 Marcola Rd
Springfield, OR 97477
Phone (541) 746-9424
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | RP-0001089 | OR | Yes |
Addresses
Primary practice location
2000 Marcola Rd
Springfield, OR 97477-2562
Mailing address
250 E Parkcenter Blvd
Boise, ID 83706-3940
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2078123 | Other | PK | |
| 004957 | Medicaid | OR |
Other names
- SAV-ON PHARMACY #0570
Other providers in Springfield, OR
- Nora Marie Ahlgren
- Yumi Aikawa
- Aims Vascular Access, LLC
- Katherine Melissa Ainslie-Wallace
- Ossama Al Masalmeh
- Albertsons LLC
- Alexander K Morley MD PC
- Jared Alexander
- Rajeev L Alexander
- Rachelle Alford
All providers in Springfield, OR · Community/Retail Pharmacy in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2020. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.