Provider Demographics
NPI:1073994836
Name:ALBERTSONS
Entity Type:Organization
Organization Name:ALBERTSONS
Other - Org Name:SAVEON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELDAHMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-461-2100
Mailing Address - Street 1:543 SWEETWATER RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-5627
Mailing Address - Country:US
Mailing Address - Phone:619-461-2100
Mailing Address - Fax:619-461-2965
Practice Address - Street 1:543 SWEETWATER RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977
Practice Address - Country:US
Practice Address - Phone:619-461-2100
Practice Address - Fax:619-461-2965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA513753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy