Albertsons LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y04556 Issued in AZ

Legal business name

ALBERTSONS LLC

Doing business as

Osco Drug #2952

Practice address

8035 N 19TH Ave
Phoenix, AZ 85021-5159

Phone

(602) 678-0594

Fax

(602) 906-9304

NPI assigned

Jun 4, 2006

Organization subpart

No

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

Authorized official

Name

Kathy Giannakopoulos

Title

Enrollment Manager

Phone

(208) 395-3954

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Osco Drug #2952 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, AZ2 enrollments

Enrollment records 2

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

Locations

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1871532259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8035 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215159",
            "telephone_number": "602-678-0594",
            "fax_number": "602-906-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERTSONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "GIANNAKOPOULOS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "208-395-3954"
    },
    "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": "AZ",
            "license": "Y04556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100540",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1989393",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Osco Drug #2952",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Osco Drug #2952",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Albertsons LLC
• Albertsons LLC
• Albertsons LLC
• Albertsons LLC
• Albertsons LLC
• Albertsons Pharmacy
• Julie Alberty, PH.D.
• Jesse Clayton Albin, BSN, RN
• Leah Albornoz-Sanchez, ND
• Albrecht & Stavoe DDS PLLC

• Community/Retail Pharmacy in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.