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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	22290	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2098159	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366489825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBERTSONS LLC

Provider Business Mailing Address
First Line	:	250 E PARKCENTER BLVD
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83706-3940
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6220 HIGHWAY 287
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-2800
Country	:	US
Telephone Number	:	817-478-1313
Fax Number	:	817-478-0227

Authorized Official
Title or Position	:	ENROLLMENT MANAGER
Name	:	KATHY GIANNAKOPOULOS
Credential	:
Telephone Number	:	208-395-3954

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	06/16/2025

Similar Medicare Providers

1710106117 — MRS. VALARIE ELAINE MEYER P.T.
Practice Location Address:

2800 CONNECTICUT LN
ARLINGTON, TX
76001-5504

Practice Phone: 817-465-5535
Practice Fax:

1609257856 — VICTOR REYNEKE
Practice Location Address:

6220 HIGHWAY 287
ARLINGTON, TX
76001-2800

Practice Phone: 817-478-1313
Practice Fax: 817-478-0227

1285356584 — QUYEN ANH TRAN
Practice Location Address:

6220 US 287 HWY
ARLINGTON, TX
76001-2800

Practice Phone: 817-478-1313
Practice Fax:

1851149504 — 1918 WINTER STREET OPERATING CO LLC
Practice Location Address:

6220 HIGHWAY 287
ARLINGTON, TX
76001-2800

Practice Phone: 817-478-1313
Practice Fax: 817-478-0227

1316210230 — PHYSICAL MEDICINE ASSOCIATES LTD
Practice Location Address:

2800 S SHIRLINGTON RD , SUITE 102
ARLINGTON, VA
22206-3601

Practice Phone: 703-738-4336
Practice Fax: 703-998-8256

1336001122 — SHIRLEY-VICTORY NWAJEI RN
Practice Location Address:

2800 CLARENDON BLVD APT 321
ARLINGTON, VA
22201-7012

Practice Phone: 540-222-8986
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 © 2007-2025 (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.