Active NPI
Albertsons LLC
- Community/Retail Pharmacy
- Moorpark, CA
National Provider Identifier
1407802424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY51311
- Legal business name
- ALBERTSONS LLC
- Practice address
- 475 W Los Angeles Ave
Moorpark, CA 93021-1707 - Phone
- (805) 523-1441
- Fax
- (805) 523-2804
- NPI assigned
- May 25, 2006
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Diona Townsend
- Title
- Asst Manager Plan Implementation
- Phone
- (847) 916-4513
Member of 7
Organizations this organization is a member of, according to the National Provider Directory.
National Provider Directory
National Provider DirectoryLocations
475 W Los Angeles Ave
Moorpark, CA 93021
Phone (805) 523-1441
Specialties & licenses 3
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY51311 | CA | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
475 W Los Angeles Ave
Moorpark, CA 93021-1707
Mailing address
250 E Parkcenter Blvd
Quarry B BLDG
Boise, ID 83706-3940
Phone (208) 395-3436
Other identifiers 3
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000500 | Other | PK | |
| 071PHA477480 | Medicaid | CA | |
| 071PHA456920 | Medicaid | CA |
Other names 1
NPPES NPI Registry- SAVON PHARMACY
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 25, 2013.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1374710400000",
"number": "1407802424",
"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": "475 W LOS ANGELES AVE",
"city": "MOORPARK",
"state": "CA",
"postal_code": "930211707",
"telephone_number": "805-523-1441",
"fax_number": "805-523-2804"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALBERTSONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-25",
"last_updated": "2013-07-25",
"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": "PHY51311",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2000500",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "071PHA477480",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "071PHA456920",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SAVON PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Moorpark, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.