Albertsons LLC
Organization Active NPI Community/Retail Pharmacy · Spokane Valley, WA
NPI 1932155447 · NPPES record last updated May 16, 2023
Key facts
- NPI
- 1932155447
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHAR.CF.60342908 (WA)
- Legal business name
- ALBERTSONS LLC
- Practice address
- 13606 E 32ND Ave
Spokane Valley, WA 99216 - Phone
- (509) 892-3659
- Fax
- (509) 892-6000
- NPI assigned
- May 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Kathy Giannakopoulos
- Title
- Enrollment Manager
- Phone
- (208) 395-3954
Corporate family (same tax ID) 13
Member of 7
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Safeway Pharmacy #0258 |
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 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130702000149 | WA | DME Supplier - Pharmacy |
8729983515 | Practice locations: Spokane Valley, WA |
National Provider Directory
- Tax ID family
- Albertsons 851
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHAR.CF.60342908 | WA | Yes |
Addresses
Primary practice location
13606 E 32ND Ave
Spokane Valley, WA 99216
Mailing address
250 E Parkcenter Blvd
Boise, ID 83706-3940
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6022719 | Medicaid | WA | |
| 2110616 | Other | PK |
Other names
- Safeway Pharmacy # 0258
Other providers in Spokane Valley, WA
- Aim Counseling LLC
- Olubukonla Elizabeth Alabi
- Fola Sade Alade
- Jack Raymond Albert
- Albertsons LLC
- Teresa Lynn Albion
- Alexis Rae Aldridge
- Nichole Paige Alexander
- Sheryl Alexander
- Bryan Alfaro
All providers in Spokane Valley, WA · Community/Retail Pharmacy in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2023. 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.