Active NPI
Albertsons LLC
Doing business as Osco Pharmacy #0019
- Community/Retail Pharmacy
- Lewistown, MT
National Provider Identifier
1619923539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHA-PHR-LIC-14919
- Legal business name
- ALBERTSONS LLC
- Doing business as
- Osco Pharmacy #0019
- Practice address
- 117 W Janeaux St
Lewistown, MT 59457-3073 - Phone
- (406) 538-6674
- Fax
- (406) 538-6675
- NPI assigned
- May 25, 2006
- Last updated
- Apr 1, 2020
- 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
- Kathy Giannakopoulos
- Title
- Enrollment Manager
- Phone
- (208) 395-3954
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHA-PHR-LIC-14919 | MT | Primary |
Addresses
Primary practice location
117 W Janeaux St
Lewistown, MT 59457-3073
Mailing address
250 E Parkcenter Blvd
Boise, ID 83706-3940
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0210698 | Medicaid | MT | |
| 0214710 | Medicaid | MT | |
| 2051955 | Other | PK |
Other names 1
- OSCO PHARMACY #0019
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130812000253 | MT | DME Supplier - Pharmacy | 8729983515 | Practice locations: Lewistown, MT |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 27D1031940 | Osco Pharmacy #0019 | Certificate of waiver | Oct 12, 2026 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Osco Pharmacy #0019 | 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 |
National Provider Directory
National Provider Directory- Tax ID family
- Albertsons 851
Organizations with this tax ID in the same state 20
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Member of 5
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Osco Drug #3346
- Community/Retail Pharmacy
- Elmhurst, IL
- NPI 1699721225
Member Of
-
dba Osco Drug #3096
- Community/Retail Pharmacy
- Munster, IN
- NPI 1679529101
Member Of
-
dba Safeway Pharmacy #3252
- Community/Retail Pharmacy
- Moses Lake, WA
- NPI 1730125592
Member Of
-
dba Shaws Pharmacy #2601
- Community/Retail Pharmacy
- Littleton, NH
- NPI 1053367672
Member Of
-
dba Albertsons Market Pharmacy #0903
- Community/Retail Pharmacy
- Rio Rancho, NM
- NPI 1316984834
Member Of
Locations
117 W Janeaux St
Lewistown, MT 59457
Phone (406) 538-2911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1585699200000",
"number": "1619923539",
"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": "117 W JANEAUX ST",
"city": "LEWISTOWN",
"state": "MT",
"postal_code": "594573073",
"telephone_number": "406-538-6674",
"fax_number": "406-538-6675"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALBERTSONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-25",
"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": "MT",
"license": "PHA-PHR-LIC-14919",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0210698",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0214710",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2051955",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "OSCO PHARMACY #0019",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lewistown, MT
Sources for this page
- 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.