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Contact Information

ALBERTSONS LLC
1865 COFFEEN AVE
SHERIDAN, WY82801-5711
 Phone: 307-672-8908
 Fax: 307-672-5445
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for ALBERTSONS LLC

NPI Number 1225212723
LBN Legal business name ALBERTSONS LLC
Authorized official TIFFANY ELIOPULOS - (ASSISTANT MANAGER, ENROLLMENTS)
Entity Organization
Organization subpart 1 No
Enumeration date 12/20/2007
Last updated 09/11/2018 - About 8 years ago
Identifiers
WY License # R10148
WY Medicaid 125400600
Other 2111699 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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