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General NPI Number Information
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NPI Number | 1518341577
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Entity Type | Organization
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Legal Business Name | ALBERTSON'S
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Dates
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Enumeration Date | 07/18/2015
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Last Update Date | 07/18/2015
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Provider Practice Location Address
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Address Line | 6107 S ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-2743
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Country | US
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Telephone | 773-735-0396
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Fax |
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Provider Business Mailing Address
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Address Line | 150 E PIERCE RD
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City | ITASCA
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State | IL
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Zip | 60143-1222
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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 | PHARMACIST
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Name | PATRYK BEC
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Credential | PHARM.D.
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Telephone | 815-955-6157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 051298644
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License Number State | IL
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