ALBERTSONS PHARMACY #0199
NPI 1073551214
Pharmacy - Community/Retail Pharmacy in Boise, ID

Active since June 02, 2006CLIA 13D1035486 · Waiver
1219 S BROADWAY AVE, BOISE, ID 83706(208) 433-9905(208) 433-9907 Get Directions Write a Review

NPPES record last updated: April 2, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 2, 2020, Jul 20, 2018, May 10, 2018 and 1 more (4 updates tracked since 2016).

About Albertsons Pharmacy #0199 NPPES

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

ALBERTSONS PHARMACY #0199 (NPI 1073551214) is a healthcare organization registered as a community/retail pharmacy in Boise, Idaho and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through January 3, 2027 and lists Kathy Giannakopoulos, Enrollment Manager, as its authorized official.

NPPES Registry Identity

NPI1073551214
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameALBERTSONS LLC
Location Address1219 S BROADWAY AVEBoise, ID 83706
Mailing Address250 E Parkcenter BlvdBoise, ID 83706-3940
Fax(208) 433-9907
Organization SubpartNo
Authorized OfficialKathy GiannakopoulosEnrollment Manager · (208) 395-3954
Enumeration DateJune 2, 2006
Last NPPES UpdateApril 2, 20204 updates tracked since enumeration
NPPES CertifiedApril 2, 2020
NPI 1073551214 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 ID · 21064RP
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
1219 S BROADWAY AVE, Boise, ID 83706

Other Names 1

Doing Business AsAlbertsons Pharmacy #0199

Other Identifiers 3

Medicaid805229700ID
Medicaid807494200ID
Other2021613Pk

Accepted 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 13D1035486

Albertson's Pharmacy #0199 · Boise, ID
Active · expires Jan 3, 2027
CLIA Number13D1035486
Laboratory TypePharmacy
Certificate Effective DateJanuary 4, 2025
Certificate Expiration DateJanuary 3, 2027
Laboratory DirectorTimothy Flynn
Laboratory Phone(208) 433-9905
Laboratory LocationAlbertson's Pharmacy #01991219 S Broadway Ave, Boise, ID 83706
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Albertsons Pharmacy #199 carries, from the Medicare DMEPOS supplier directory.

Albertsons Pharmacy #199

DMEPOS supplier · Boise, IDOperated by Albertsons LLC

Does not accept Medicare assignment

Albertsons Pharmacy #199 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)20624981
Medicare Participant SinceJanuary 1, 2001
Supplier Location1219 S Broadway AveBoise, ID 83706
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 8

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

Pharmacist
1219 S BROADWAY AVE
BOISE, ID 83706
Pharmacist
1219 S BROADWAY AVE
BOISE, ID 83706
Pharmacist
1219 S BROADWAY AVE
BOISE, ID 83706
Pharmacist
1219 S BROADWAY AVE
BOISE, ID 83706
Pharmacist
1219 S BROADWAY AVE
BOISE, ID 83706
Dietitian, Registered
1219 S BROADWAY AVE
BOISE, ID 83706
Pharmacist
1219 S BROADWAY AVE
BOISE, ID 83706
Pharmacist
1219 S BROADWAY AVE
BOISE, ID 83706

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073551214, enumerated as an "organization" on June 02, 2006.

The provider is located at 1219 S BROADWAY AVE BOISE, ID 83706 and the phone number is (208) 433-9905.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Arizona. Please consult your insurance carrier or call the provider to verify.