Organization · NPI-2

Albertsons LLC

Pharmacy, Community/Retail Pharmacy · Lafayette, LA

NPI number1790724177

StatusActive

Last updated in NPPESJun 18, 2025

Details

NPI: 1790724177
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 code	Description	License	State	Primary
3336C0003X	Pharmacy, Community/Retail Pharmacy	PHY.002598-RC	LA	Yes
333600000X	Pharmacy	–	–
332B00000X	Durable Medical Equipment & Medical Supplies	–	–

Other names

Albertsons Pharmacy #0719 (Doing Business As)

Practice location

4400 Ambassador Caffery Pkwy
Lafayette, LA 70508-6760

Phone 337-984-5133 · Fax 337-984-4465

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Authorized official

Kathy Giannakopoulos
Enrollment Manager
2083953954

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