Pavilions Pharmacy #4563
LBN: Albertsons Llc
Pavilions Pharmacy #4563 is an health care organization with primary practice located at 989 Avenida Pico , San Clemente CA 92673-3908. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Albertsons Llc can be contacted via phone (949) 369-5596, or through Giannakopoulos, Kathy via phone (208) 395-3954.
Contact Information
Primary practice address
989 Avenida Pico
San Clemente CA 92673-3908
Phone: (949) 369-5596
Fax: (949) 369-5691
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY51354 | California |
Profile Details
| NPI number | 1154377521 |
|---|---|
| LBN Legal business name | Albertsons Llc |
| DBA Doing business as | Pavilions Pharmacy #4563 |
| Authorized official | Giannakopoulos, Kathy |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 26th, 2006 |
| Last updated | Aug 1st, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154377521 | NPPES |
| California | MEDICAID | 071PHA477040 | |
| California | MEDICAID | 071PHA457770 | |
| California | Other | 2000502 |
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