Albertsons LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y04594 Issued in AZ

Legal business name

ALBERTSONS LLC

Doing business as

Osco Drug #0004

Practice address

3130 W Carefree Hwy
Phoenix, AZ 85086-3200

Phone

(623) 582-2743

Fax

(623) 582-8074

NPI assigned

Jun 4, 2006

Last updated

Apr 1, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathy Giannakopoulos

Title

Enrollment Manager

Phone

(208) 395-3954

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• OSCO DRUG #0004 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, AZ2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Safeway Inc

  dba Safeway Phamracy #4837

  • Community/Retail Pharmacy
  • District Heights, MD
  • NPI 1588600191

  Member Of

  NPD member
• Star Markets Company Inc

  dba Shaws Pharmacy #2594

  • Community/Retail Pharmacy
  • Marshfield, MA
  • NPI 1548216070

  Member Of

  NPD member
• United Supermarkets LLC

  dba Albertsons Market Pharmacy #0904

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1124067509

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1578502951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 W CAREFREE HWY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850863200",
            "telephone_number": "623-582-2743",
            "fax_number": "623-582-8074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERTSONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "GIANNAKOPOULOS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "208-395-3954"
    },
    "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": "AZ",
            "license": "Y04594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1991596",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099624",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSCO DRUG #0004",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Albertsons LLC (Osco Drug)
• Albertsons LLC (Osco Drug #2985)
• Albertsons LLC (Osco Pharmacy)
• Albertsons LLC (Osco Drug)
• Albertsons LLC (Albertsons Pharmacy #0025)
• Albertsons LLC (Osco Drug #2952)
• Albertsons Pharmacy
• Julie Alberty, PH.D.
• Jesse Clayton Albin, BSN, RN
• Leah Albornoz-Sanchez, ND

• Community/Retail Pharmacy in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.