Albertsons LLC – Community/Retail Pharmacy

Key facts

NPI: 1811934375
Entity type: Organization (NPI type 2)
Primary specialty: Community/Retail Pharmacy 3336C0003X
License: 21989 (TX)
Legal business name: ALBERTSONS LLC
Practice address: 9300 Clifford St
Fort Worth, TX 76108-4426
Phone: (817) 246-4909
Fax: (817) 246-3247
NPI assigned: Jun 1, 2006
Organization subpart: No

Authorized official

Name: Kathy Giannakopoulos
Title: Enrollments Manager
Phone: (208) 395-3954

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

NPD member Member Of
Star Markets Company Inc Community/Retail Pharmacy · Marshfield, MA · NPI 1548216070

NPD member Member Of
United Supermarkets LLC Community/Retail Pharmacy · Albuquerque, NM · NPI 1134166655

NPD member Member Of

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

William Prater, PHARMD Pharmacist · Fort Worth, TX · NPI 1831706605

NPD (past)
Ellen Jane Sinatra Pharmacist · Fort Worth, TX · NPI 1053772947

NPD (past)

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
45D1032492	Albertsons Pharmacy #4223 9300 Clifford Street, Fort Worth, TX 76108	Certificate of waiver	Jan 9, 2028

Medicare medical equipment & supply locations

Supplier	Supplies	Medicare assignment
Sav-on Pharmacy #4223 9300 Clifford St, Fort Worth, TX 76108-4426 · (817) 246-4909	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 Participating since Jan 1, 2001

Medicare participation

Medicare fee-for-service enrollment: Enrolled (2 enrollments) in TX

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
O20100930058998	TX	DME Supplier - Pharmacy DME Supplier - Grocery Store	8729983515	Practice locations: Fort Worth, TX

National Provider Directory

Locations

9300 Clifford St
Fort Worth, TX 76108
Phone (817) 246-4909

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Durable Medical Equipment & Medical Supplies	332B00000X
Pharmacy	333600000X
Community/Retail Pharmacy	3336C0003X	21989	TX	Yes

Addresses

Primary practice location

9300 Clifford St
Fort Worth, TX 76108-4426

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other identifiers

Identifier	Type	State	Issuer
2097882	Other		PK
465262	Medicaid	TX

Other names

Albertsons Pharmacy #4223 Doing business as
SAVON PHARMACY Doing business as

Other providers in Fort Worth, TX

All providers in Fort Worth, TX · Community/Retail Pharmacy in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2025. 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.
Medicare Care Compare provider data (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.