PAVILIONS PHARMACY #4563
NPI 1154377521
Pharmacy - Community/Retail Pharmacy in San Clemente, CA

Q: What is Albertsons LLC's NPI number?

The NPI number for Albertsons LLC is 1154377521. It was assigned to this organization in the NPPES registry on May 26, 2006. The provider is doing business as Pavilions Pharmacy #4563.

Q: What is Albertsons LLC's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Albertsons LLC was last updated on August 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 26, 2006

989 AVENIDA PICO, SAN CLEMENTE, CA 92673(949) 369-5596(949) 369-5691 Get Directions Write a Review

NPPES record last updated: August 1, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 8, 2020, Sep 28, 2018, Jul 19, 2018 and 1 more (4 updates tracked since 2016).

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About Pavilions Pharmacy #4563 NPPES

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

PAVILIONS PHARMACY #4563 (NPI 1154377521) is a healthcare organization registered as a community/retail pharmacy in San Clemente, California and active in the NPI registry since May 2006. The organization lists Kathy Giannakopoulos, Enrollment Manager, as its authorized official.

NPPES Registry Identity

NPI1154377521

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameALBERTSONS LLC

Location Address989 AVENIDA PICOSan Clemente, CA 92673-3908

Mailing Address250 E Parkcenter BlvdBoise, ID 83706-3940

Phone(949) 369-5596

Fax(949) 369-5691

Organization SubpartNo

Authorized OfficialKathy GiannakopoulosEnrollment Manager · (208) 395-3954

Enumeration DateMay 26, 2006

Last NPPES UpdateAugust 1, 20234 updates tracked since enumeration

NPPES CertifiedAugust 1, 2023

✔ NPI 1154377521 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 CA · PHY51354

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

989 AVENIDA PICO, San Clemente, CA 92673

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Other Names 1

Doing Business AsPavilions Pharmacy #4563

Other Identifiers 3

Medicaid071PHA477040CA

Medicaid071PHA457770CA

Other2000502Pk

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 ›

Other Providers at the Same Location NPPES 7

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

WAYNE JOSEPH DI PIETRO RPH

Pharmacist