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Contact Information

ALBERTSONS LLC
110 W SANDY LAKE RD
COPPELL, TX75019-2015
 Phone: 972-462-7260
 Fax: 972-393-0037
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for ALBERTSONS LLC

NPI # 1790723153
LBN Legal business name ALBERTSONS LLC
Authorized official LORENZO TORRES - (NEW STORE ENROLLMENTS)
Entity Organization
Organization subpart 1 No
Enumeration date 06/04/2006
Last updated 11/21/2007 - About 19 years ago
Identifiers
TX License # 14826
TX Medicaid 463368
Other 4585127 OTHER ID NUMBER
Other 4585127 OTHER ID NUMBER-COMMERCIAL NUMBER
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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