Albertsons LLC
Organization Active NPI Community/Retail Pharmacy · Thornton, CO
NPI 1790723872 · NPPES record last updated Apr 3, 2020
Key facts
- NPI
- 1790723872
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 150000050 (CO)
- Legal business name
- ALBERTSONS LLC
- Practice address
- 3840 E 104TH Ave
Thornton, CO 80233-4436 - Phone
- (303) 255-0587
- Fax
- (303) 255-0435
- NPI assigned
- Jun 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Kathy Giannakopoulos
- Title
- Enrollment Manager
- Phone
- (208) 395-3954
Member of 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041014000405 | TX | Part B Supplier - Centralized Flu Biller | 8729983515 |
This NPI is an additional NPI on the enrollment Practice locations: Boise, ID |
| O20100930039322 | CO | DME Supplier - Pharmacy |
8729983515 | Practice locations: Thornton, CO |
National Provider Directory
Locations
3840 E 104th Ave
Thornton, CO 80233
Phone (303) 255-0587
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 150000050 | CO | Yes |
Addresses
Primary practice location
3840 E 104TH Ave
Thornton, CO 80233-4436
Mailing address
250 E Parkcenter Blvd
Boise, ID 83706-3940
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20030533 | Medicaid | CO | |
| 2003279 | Other | PK |
Other names
- SAFEWAY PHARMACY #892
Other providers in Thornton, CO
- Tahereh Mona Akbari
- Sunsiarae Akquia
- Paul Al-Attar
- Jose Alarcon
- Vanessa Elizabeth Alarcon
- Robert Albrecht
- Anahy Alcantar
- Austin Alexander
- All About Chiropractic - North Denver, PLLC
- All in Bloom Therapy
All providers in Thornton, CO · Community/Retail Pharmacy in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.