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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
1333600000XPharmacy22365TX
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14526440OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1992742456
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALBERTSONS LLC
Provider Business Mailing Address
First Line : 3750 GATTIS SCHOOL RD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-4642
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3750 GATTIS SCHOOL RD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-4642
Country : US
Telephone Number : 512-255-7876
Fax Number : 512-255-1714
Authorized Official
Title or Position : NEW STORE ENROLLMENTS
Name : LORENZO TORRES
Credential :
Telephone Number : 847-916-4463
Provider Enumeration Date : 06/01/2006
Last Update Date : 09/11/2025

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Directions to “ALBERTSONS LLC ” Practice Location

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