Albertsons LLC
Organization Active NPI Community/Retail Pharmacy · Fort Worth, TX
NPI 1497793582 · NPPES record last updated Nov 25, 2009
Key facts
- NPI
- 1497793582
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 16048 (TX)
- Legal business name
- ALBERTSONS LLC
- Practice address
- 3120 S University Dr
Fort Worth, TX 76109-5614 - Phone
- (817) 921-9797
- Fax
- (817) 924-8756
- NPI assigned
- Jun 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Dan Johnson
- Title
- Manager Managed Healthcare
- Phone
- (208) 395-3436
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Albertsons 851
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 16048 | TX | Yes |
Addresses
Primary practice location
3120 S University Dr
Fort Worth, TX 76109-5614
Mailing address
3030 Cullerton St
Franklin Park, IL 60131-2205
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4591740 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| 463704 | Medicaid | TX |
Other names
- SAVON PHARMACY
Other providers in Fort Worth, TX
- Thomas Alberti
- Maria Albertson
- Albertsons LLC
- Albertsons LLC
- Albertsons LLC
- Albertsons LLC
- Albertsons LLC
- Albertsons LLC
- Albertsons LLC
- Albertsons LLC
All providers in Fort Worth, TX · Community/Retail Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.