Organization · NPI-2
Albertsons LLC
Pharmacy, Community/Retail Pharmacy · Tyler, TX
NPI number1063459527
StatusActive
Last updated in NPPESDec 3, 2010
Details
- NPI
- 1063459527
- Entity type
- Organization (NPI-2)
- Legal business name
- Albertsons LLC
- Organization subpart
- No
- Enumeration date
- Jun 1, 2006
- Last updated
- Dec 3, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 13081 | TX | Yes |
| 333600000X | Pharmacy | – | – | |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Savon Pharmacy (Doing Business As)
Practice location
1900 E Se Loop 323Tyler, TX 75701-8337
Phone 903-597-8081 · Fax 903-597-6296
Mailing address
3030 Cullerton StFranklin Park, IL 60131-2205
Authorized official
Dan Johnson
Manager Managed Healthcare
2083953436
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