NPIMap

Organization Active NPI

Albertsons LLC

Doing business as Sav on Pharmacy #0101

  • Community/Retail Pharmacy
  • Boise, ID
National Provider Identifier
1841246352
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
21061RP Issued in ID
Legal business name
ALBERTSONS LLC
Doing business as
Sav on Pharmacy #0101
Practice address
1650 W State St
Boise, ID 83702-4040
Phone
(208) 344-8660
Fax
(208) 343-1343
NPI assigned
May 26, 2006
Last updated
Sep 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Authorized official

Name
Tiffany Eliopulos
Title
Assistant Manager, Enrollments
Phone
(208) 395-3906

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 21061RP ID Primary

Addresses

Primary practice location

1650 W State St
Boise, ID 83702-4040

Mailing address

250 E Parkcenter Blvd
Mailstop Sec2-B
Boise, ID 83706-3940
Phone (208) 395-3436

Other identifiers 3

IdentifierTypeStateIssuer
2020566OtherPK
807493600MedicaidID
002256900MedicaidID

Other names 1

  • SAV ON PHARMACY #0101 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130802000040 ID DME Supplier - PharmacyDME Supplier - Grocery Store 8729983515 Practice locations: Boise, ID

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D1035402Sav-on Pharmacy #01011650 W State St, Boise, ID 83702Certificate of waiverJan 2, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Sav-on Pharmacy #01011650 W State St, Boise, ID 83702-4040(208) 344-8660 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 assignmentParticipating since Jan 1, 2001

National Provider Directory

National Provider Directory
Tax ID family
Albertsons Inc 4103388 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Member of 7

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1841246352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "address_2": "MAILSTOP SEC2-B",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940",
            "telephone_number": "208-395-3436",
            "fax_number": "208-495-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024040",
            "telephone_number": "208-344-8660",
            "fax_number": "208-343-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERTSONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "ELIOPULOS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "ASSISTANT MANAGER, ENROLLMENTS",
        "authorized_official_telephone_number": "208-395-3906"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "21061RP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2020566",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807493600",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002256900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAV ON PHARMACY #0101",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.

Verify at the official NPI Registry.