MEDICARE: ALBERTSONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PH14195	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1078181	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1942247614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBERTSONS LLC

Provider Business Mailing Address
First Line	:	26841 S TAMIAMI TRL
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7817
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26841 S TAMIAMI TRL
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7817
Country	:	US
Telephone Number	:	239-947-1922
Fax Number	:	239-947-3058

Authorized Official
Title or Position	:	NEW STORE ENROLLMENTS
Name	:	MR. LORENZO TORRES III
Credential	:
Telephone Number	:	847-916-4463

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	04/25/2008

Similar Medicare Providers

1578715538 — PUBLIX SUPER MARKETS INC
Practice Location Address:

26841 TAMIAMI TRL
BONITA SPRINGS, FL
34134-7817

Practice Phone: 239-992-1675
Practice Fax: 239-992-2741

1679562086 — DR. ANN MCDANIEL PSYD LMHC
Practice Location Address:

452 OSCEOLA ST , SUITE 106
ALTAMONTE SPRINGS, FL
32701-7817

Practice Phone: 407-265-6100
Practice Fax:

1205064649 — MRS. KECIA WARD CROOM M.S.
Practice Location Address:

452 OSCEOLA ST , SUITE 114
ALTAMONTE SPRINGS, FL
32701-7817

Practice Phone: 321-230-4118
Practice Fax:

1427336494 — MR. TERRY BLAKENEY
Practice Location Address:

1200 HARRIS SPRINGS ROAD
LAS VEGAS, NV
89124-7817

Practice Phone: 702-872-5382
Practice Fax:

1043569379 — BARTOLOME E COLOM LMHC
Practice Location Address:

452 OSCEOLA ST , SUITE 101
ALTAMONTE SPRINGS, FL
32701-7817

Practice Phone: 407-782-5525
Practice Fax: 386-943-9976

1962748814 — SUMMER KATZ, LMHC, LLC
Practice Location Address:

452 OSCEOLA ST , SUITE 113
ALTAMONTE SPRINGS, FL
32701-7817

Practice Phone: 407-733-2110
Practice Fax:

Directions to “ALBERTSONS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.