Organization · NPI-2

Albertsons LLC

Pharmacy, Community/Retail Pharmacy · Casper, WY

NPI number1508040007
StatusActive
Last updated in NPPESApr 1, 2020

Details

NPI
1508040007
Entity type
Organization (NPI-2)
Legal business name
Albertsons LLC
Organization subpart
No
Enumeration date
Dec 20, 2007
Certification date
Apr 1, 2020
Last updated
Apr 1, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail PharmacyR10099WYYes
332B00000X Durable Medical Equipment & Medical Supplies––

Other names

  • Osco Pharmacy #0060 (Doing Business As)

Practice location

1076 Cy Ave
Casper, WY 82604-3561

Phone 307-266-0156 · Fax 307-266-4982

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Authorized official

Kathy Giannakopoulos
Enrollment Manager
2083953954

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