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NPI Code Detail

MEDICARE: ALBERTSONS LLC

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
1333600000XPharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
33336C0003XCommunity/Retail PharmacyPH18583FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21095478OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1841237518
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALBERTSONS LLC
Provider Business Mailing Address
First Line : 3030 CULLERTON ST
Second Line :
City : FRANKLIN PARK
State : IL
Zip : 60131-2205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10863 BLOOMINGDALE AVE
Second Line :
City : RIVERVIEW
State : FL
Zip : 33578-3616
Country : US
Telephone Number : 813-662-1868
Fax Number : 813-662-2723
Authorized Official
Title or Position : MANAGER PLAN IMPLEMENTATION
Name : JULIE SCHREINER
Credential :
Telephone Number : 847-916-4711
Provider Enumeration Date : 06/01/2006
Last Update Date : 12/30/2008

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Directions to “ALBERTSONS LLC ” Practice Location

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