NPI | 1407211204 |
---|---|
Doing Business As | ALBERTSONS PHARMACY #3203 |
Entity Type | Organization |
Authorized Contact | KATHY GIANNAKOPOULOS Enrollment Manager 208-395-3954 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AZ Y006762) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
333600000X Pharmacy | |
Enumeration Date | 2015-12-21 |
Last Update Date | 2022-08-17 |