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ALBERTSONS PHARMACY #0611
NPI 1013956499
Pharmacy - Community/Retail Pharmacy in Texarkana, AR

Active since June 04, 2006CLIA 04D2036380 · Waiver
3710 N STATE LINE AVE, TEXARKANA, AR 71854(870) 773-5521(870) 774-8426 Get Directions Write a Review

NPPES record last updated: August 21, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 21, 2024, Apr 3, 2020, Oct 5, 2018 and 1 more (4 updates tracked since 2018).

About Albertsons Pharmacy #0611 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALBERTSONS PHARMACY #0611 (NPI 1013956499) is a healthcare organization registered as a community/retail pharmacy in Texarkana, Arkansas and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through February 6, 2028 and lists Kathy Giannakopoulos, Enrollment Manager, as its authorized official.

NPPES Registry Identity

NPI1013956499
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameALBERTSONS LLC
Location Address3710 N STATE LINE AVETexarkana, AR 71854-1934
Mailing Address250 E Parkcenter BlvdBoise, ID 83706-3940
Phone(870) 773-5521
Fax(870) 774-8426
Organization SubpartNo
Authorized OfficialKathy GiannakopoulosEnrollment Manager · (208) 395-3954
Enumeration DateJune 4, 2006
Last NPPES UpdateAugust 21, 20244 updates tracked since enumeration
NPPES CertifiedAugust 21, 2024
✔ NPI 1013956499 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in AR · AR17558
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
3710 N STATE LINE AVE, Texarkana, AR 71854
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Other Names 1

Doing Business AsAlbertsons Pharmacy #0611

Other Identifiers 2

Other1995178Pk
Medicaid121367407AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D2036380

Albertsons Pharmacy #0611 · Texarkana, AR
Active · expires Feb 6, 2028
CLIA Number04D2036380
Laboratory TypePharmacy
Certificate Effective DateFebruary 7, 2026
Certificate Expiration DateFebruary 6, 2028
Laboratory DirectorHari P. Ramineni
Laboratory Phone(870) 773-5521
Laboratory LocationAlbertsons Pharmacy #06113710 N State Line Ave, Texarkana, AR 71854
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Sav-On Pharmacy #0611 carries, from the Medicare DMEPOS supplier directory.

Sav-On Pharmacy #0611

DMEPOS supplier · Texarkana, AROperated by Albertsons LLC
⋮

Does not accept Medicare assignment

Sav-On Pharmacy #0611 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20621387
Medicare Participant SinceJanuary 1, 2001
Supplier Location3710 State Line AveTexarkana, AR 71854
Phone(870) 773-5521
Supplier Specialties
Pharmacy Grocery Store

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AUSTIN SEWELL
Pharmacist (Ambulatory Care)
3710 N STATE LINE AVE
TEXARKANA, AR 71854
Miller County (870) 773-5521
DR. CHRISTOPHER BRENT PANNECK PHARMD
Pharmacist
3710 N STATE LINE AVE
TEXARKANA, AR 71854
Miller County (870) 774-3146
MRS. JENNIFER HAMMETT RPH
Pharmacist
3710 N STATE LINE AVE
TEXARKANA, AR 71854
Miller County (870) 773-5521
LEIGH HADAWAY
Pharmacist
3710 N STATE LINE AVE
TEXARKANA, AR 71854
Miller County (870) 773-2399
DR. ANGELA DENISE CALHOON PHARMD
Pharmacist
3710 N STATE LINE AVE
TEXARKANA, AR 71854
Miller County (870) 773-5521
MILLARD FORMBY III
Pharmacist
3710 N STATE LINE AVE
TEXARKANA, AR 71854
Miller County (870) 773-5521

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Albertsons LLC's NPI number?

The NPI number for Albertsons LLC is 1013956499. It was assigned to this organization in the NPPES registry on June 4, 2006. The provider is doing business as Albertsons Pharmacy #0611.

Where is Albertsons LLC located?

Albertsons LLC is located at 3710 N State Line Ave, Texarkana, AR 71854. The listed phone number is (870) 773-5521.

What is Albertsons LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Albertsons LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Sav-On Pharmacy #0611 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Albertsons LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2036380) is associated with this NPI, valid through February 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Albertsons LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Arizona Complete Health and Ambetter from Arkansas Health & Wellness and 46 other insurers list Albertsons LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Albertsons LLC was last updated on August 21, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.