Organization · NPI-2

Albertsons LLC

Pharmacy, Community/Retail Pharmacy · Baton Rouge, LA

NPI number1063451441
StatusActive
Last updated in NPPESJun 18, 2025

Details

NPI
1063451441
Entity type
Organization (NPI-2)
Legal business name
Albertsons LLC
Organization subpart
No
Enumeration date
Jun 4, 2006
Certification date
Jun 18, 2025
Last updated
Jun 18, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail PharmacyPHY.004622-RCLAYes
332B00000X Durable Medical Equipment & Medical Supplies––
333600000X Pharmacy––

Other names

  • Albertsons Pharmacy #3792 (Doing Business As)

Practice location

9960 Bluebonnet Blvd
Baton Rouge, LA 70810-6457

Phone 225-768-7950 · Fax 225-768-7937

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Authorized official

Kathy Giannakopoulos
Enrollment Manager
2083953954

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