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Export Provider Record NPI 1124074638
Albertsons Llc
Organization Subpart: NO
Active
NPI Number1124074638
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1124074638
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-05-26
Last Updated2020-04-03
Authorized OfficialKathy Giannakopoulos
Enrollment Managment
Phone: 2083953954
Mailing Address250 E Parkcenter Blvd
Boise, ID 83706-3940
United States
📍 View Map
Primary Practice Address14201 Jeffrey Rd
Irvine, CA 92620-3405
United States
Phone: (949) 733-0945 | Fax: (949) 733-0985
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCA071PHA463500
MEDICAIDCA071PHA477590
Other (non-Medicare)1999420PK
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No332B00000X – Durable Medical Equipment & Medical Supplies
No333600000X – Pharmacy
Yes3336C0003X – Pharmacy, Community/Retail PharmacyCAPHY51384
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About NPI 1124074638

Albertsons Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1124074638. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Irvine, CA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-05-26. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1124074638?

NPI 1124074638 belongs to Albertsons Llc, a Pharmacy, Community/Retail Pharmacy in Irvine, CA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1124074638 active?

The current status of NPI 1124074638 in the NPPES registry is Active. The record was last updated on 2020-04-03.

What specialty is NPI 1124074638?

NPI 1124074638 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 1124074638?

You can verify NPI 1124074638 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 1124074638?

The primary practice address on file for NPI 1124074638 is 14201 Jeffrey Rd, Irvine, CA 92620-3405. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1124074638 issued?

NPI 1124074638 was first issued (enumerated) on 2006-05-26. The NPPES record was last updated on 2020-04-03.

Practice Location Map

Albertsons Llc is located at 14201 Jeffrey Rd, Irvine, CA. Use the map below to find directions or verify the practice location.

📍 14201 Jeffrey Rd, Irvine, CA 92620-3405  ·  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 1124074638. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy, Community/Retail PharmacyPHY51384CA
Data Verified from CMS NPPES Last synced: 2026-06-29 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162