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Contact Information

ALBERTSONS LLC
4415 W 7TH ST
WAKE VILLAGE, TX75501
 Phone: 903-831-5882
 Fax: 903-831-6421
 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
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for ALBERTSONS LLC

NPI Number 1871530204
LBN Legal business name ALBERTSONS LLC
Authorized official KATHY GIANNAKOPOULOS - (ENROLLMENT MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/02/2006
Last updated 06/16/2025 - About 12 months ago
Identifiers
TX License # 18610
TX Medicaid 464120
Other 2096104 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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