Albertsons LLC
Organization Active NPI Community/Retail Pharmacy · Melbourne, FL
NPI 1891733044 · NPPES record last updated Nov 30, 2009
Key facts
- NPI
- 1891733044
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PH0014084 (FL)
- Legal business name
- ALBERTSONS LLC
- Practice address
- 2447 100 Wickham Rd
Melbourne, FL 32935 - Phone
- (321) 242-1955
- Fax
- (321) 757-6306
- NPI assigned
- Jun 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Dan Johnson
- Title
- Manager Managed Healthcare
- Phone
- (208) 395-3436
Corporate family (same tax ID) 18
National Provider Directory
- Tax ID family
- Albertsons 851
Locations
2447 N Wickham Rd
Ste 100
Melbourne, FL 32935
Phone (321) 242-1955
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PH0014084 | FL | Yes |
Addresses
Primary practice location
2447 100 Wickham Rd
Melbourne, FL 32935
Mailing address
3030 Cullerton St
Franklin Park, IL 60131-2205
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 031510900 | Medicaid | FL | |
| 1078179 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names
- SAVON PHARMACY
Other providers in Melbourne, FL
- Zina Al Sekooty
- Hasanain Al-Khalidi
- Akram Mouied Alashari
- Melissa Alba
- Pamela Albert
- Zein Albustami
- Princesa Alcantar
- Mari Aldeghi
- Kyon Alderman
- Alba Aldridge
All providers in Melbourne, FL · Community/Retail Pharmacy in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2009. 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.