Active NPI
Albertsons LLC
- Community/Retail Pharmacy
- Fort Collins, CO
National Provider Identifier
1386681807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 440000003
- Legal business name
- ALBERTSONS LLC
- Practice address
- 1636 N College Ave
Fort Collins, CO 80524-1219 - Phone
- (970) 416-5832
- Fax
- (970) 416-7564
- NPI assigned
- Jun 1, 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 MGR 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 | 440000003 | CO | Primary |
Addresses
Primary practice location
1636 N College Ave
Fort Collins, CO 80524-1219
Mailing address
3030 Cullerton St
Franklin Park, IL 60131-2205
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82920052 | Medicaid | CO | |
| 2002716 | Other | PK |
Other names 1
- SAVON PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041014000405 | TX | Part B Supplier - Centralized Flu Biller | 8729983515 |
This NPI is an additional NPI on the enrollment Practice locations: Boise, ID |
National Provider Directory
National Provider DirectoryMember of 3
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1386633600000",
"number": "1386681807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 CULLERTON ST",
"city": "FRANKLIN PARK",
"state": "IL",
"postal_code": "601312205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1636 N COLLEGE AVE",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805241219",
"telephone_number": "970-416-5832",
"fax_number": "970-416-7564"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALBERTSONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-01",
"last_updated": "2013-12-10",
"status": "A",
"authorized_official_last_name": "TOWNSEND",
"authorized_official_first_name": "DIONA",
"authorized_official_title_or_position": "ASST MGR 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": "CO",
"license": "440000003",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "82920052",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2002716",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SAVON PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.