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Export Provider Record NPI 1104864537
Albertsons Llc
Organization Subpart: NO
Active
NPI Number1104864537
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1104864537
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-06-04
Last Updated2007-11-21
Authorized OfficialLorenzo Torres
NEW STORE ENROLLMENTS
Phone: 8479164463
Mailing Address3355 E Pershing Blvd
Cheyenne, WY 82001-5764
United States
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Primary Practice Address3355 E Pershing Blvd
Cheyenne, WY 82001-5764
United States
Phone: (307) 635-1155 | Fax: (307) 632-5657
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDWY124029300
Other (non-Medicare)5203384Other ID Number-Commercial Number
Other (non-Medicare)5203384Other ID Number
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No333600000X – Pharmacy
Yes3336C0003X – Pharmacy, Community/Retail PharmacyWY5203384
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About NPI 1104864537

Albertsons Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1104864537. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Cheyenne, WY. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-06-04. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1104864537?

NPI 1104864537 belongs to Albertsons Llc, a Pharmacy, Community/Retail Pharmacy in Cheyenne, WY. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1104864537 active?

The current status of NPI 1104864537 in the NPPES registry is Active. The record was last updated on 2007-11-21.

What specialty is NPI 1104864537?

NPI 1104864537 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1104864537?

You can verify NPI 1104864537 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1104864537?

The primary practice address on file for NPI 1104864537 is 3355 E Pershing Blvd, Cheyenne, WY 82001-5764. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1104864537 issued?

NPI 1104864537 was first issued (enumerated) on 2006-06-04. The NPPES record was last updated on 2007-11-21.

Practice Location Map

Albertsons Llc is located at 3355 E Pershing Blvd, Cheyenne, WY. Use the map below to find directions or verify the practice location.

📍 3355 E Pershing Blvd, Cheyenne, WY 82001-5764  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Albertsons Llc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1104864537. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy, Community/Retail Pharmacy5203384WY
Data Verified from CMS NPPES Last synced: 2026-06-26 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162