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NPI 1255378923

NPI 1255378923 : ALBERTSONS LLC : EVERGREEN, CO

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General NPI Number Information
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    NPI Number           |    1255378923
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    Entity Type          |    Organization 
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    Legal Business Name  |    ALBERTSONS LLC 
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Dates
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    Enumeration Date     |    06/01/2006
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    Last Update Date     |    12/30/2008
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Provider Practice Location Address
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    Address Line         |    30931 STAGECOACH BLVD 
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    City                 |    EVERGREEN
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    State                |    CO
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    Zip                  |    80439-2212
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    Country              |    US
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    Telephone            |    303-679-0425
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    Fax                  |    303-679-2810
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Provider Business Mailing Address
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    Address Line         |    3030 CULLERTON ST 
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    City                 |    FRANKLIN PARK
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    State                |    IL
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    Zip                  |    60131-2205
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MANAGER PLAN IMPLEMENTATION
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    Name                 |     JULIE  SCHREINER 
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    Credential           |    
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    Telephone            |    847-916-4711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    333600000X
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    Taxonomy Name        |    Pharmacy
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    400000010
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    License Number State |    CO
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