Albertsons LLC
Organization Active NPI Community/Retail Pharmacy · South Gate, CA
NPI 1689620239 · NPPES record last updated Sep 12, 2018
Key facts
- NPI
- 1689620239
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHY51409 (CA)
- Legal business name
- ALBERTSONS LLC
- Practice address
- 4155 Tweedy Blvd
South Gate, CA 90280 - Phone
- (323) 569-0744
- Fax
- (323) 569-3469
- NPI assigned
- May 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Tiffany Eliopulos
- Title
- Assistant Manager, Enrollments
- Phone
- (208) 395-3906
Member of 7
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY51409 | CA | Yes |
Addresses
Primary practice location
4155 Tweedy Blvd
South Gate, CA 90280
Mailing address
250 E Parkcenter Blvd
Mailstop Sec2-B
Boise, ID 83706-3940
Phone (208) 395-6200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 071PHA514090 | Medicaid | CA | |
| 2051723 | Other | PK |
Other names
- Sav-On Pharmacy #0142
Other providers in South Gate, CA
- Yesenia Aguirre
- Ahmed K Saad DDS Inc.
- Alamo Pharmacy Inc
- Alan Khadavi, MD, Apc
- Noor Alasady
- Joselin Aleman
- Melath Khalid Alhassan
- Aligning Paths Care Management LLC
- Allied Care Community Health Center
- Altamed Health Services Corp
All providers in South Gate, CA · Community/Retail Pharmacy in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2018. 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.