Albertsons LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH19418 Issued in FL

Legal business name

ALBERTSONS LLC

Practice address

1438 Rock Springs Rd
Apopka, FL 32712-2306

Phone

(407) 884-7968

Fax

(407) 884-9869

NPI assigned

Jun 1, 2006

Organization subpart

No

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

Authorized official

Name

Dan Johnson

Title

Manager Managed Healthcare

Phone

(208) 395-3436

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• SAVON PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Member of 3

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

• Safeway Inc

  • Community/Retail Pharmacy
  • Sunnyside, WA
  • NPI 1861421885

  Member Of

  NPD member
• Star Markets Company Inc

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

  Member Of

  NPD member
• United Supermarkets LLC

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1134166655

  Member Of

  NPD member

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1669419339",
    "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": "1438 ROCK SPRINGS RD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327122306",
            "telephone_number": "407-884-7968",
            "fax_number": "407-884-9869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERTSONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "MANAGER MANAGED HEALTHCARE",
        "authorized_official_telephone_number": "208-395-3436"
    },
    "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": "FL",
            "license": "PH19418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031543500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1099301",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAVON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Senan Al-Saadawi, MD
• Alaris ABA Services LLC
• Nicole A Albanese Hall, LMT
• Yoelbis Alberteris Suarez
• Albertsons LLC
• Nila Esther Albornoz
• Trinity Albritton
• Elizabeth Anne Albuquerque, MD
• Jannel Albury, ARNP
• Ricardo Alequin Sanchez, M.D.

• All providers in Apopka, FL
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.

Verify at the official NPI Registry.