PAVILIONS PHARMACY #4563
NPI 1154377521
Pharmacy - Community/Retail Pharmacy in San Clemente, CA
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 holds a CLIA Waiver certificate valid through March 28, 2027 and lists Kathy Giannakopoulos, Enrollment Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Other Identifiers 3
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 05D1038877
Pavilions Pharmacy #4563 · San Clemente, CAOther Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN CLEMENTE, CA 92673
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 1154377521. It was assigned to this organization in the NPPES registry on May 26, 2006. The provider is doing business as Pavilions Pharmacy #4563.
Where is Albertsons LLC located?
Albertsons LLC is located at 989 Avenida Pico, San Clemente, CA 92673. The listed phone number is (949) 369-5596.
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 hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D1038877) is associated with this NPI, valid through March 28, 2027. 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 Arkansas Health & Wellness and Ambetter from Louisiana Healthcare Connections and 40 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 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.
# Pavilions Pharmacy #4563 · NPI 1154377521
Community/Retail Pharmacy organization in San Clemente, California. Organization record, active in the CMS NPPES registry since May 26, 2006.
## Identity
- **NPI:** 1154377521 (Entity type: Organization)
- **Enumerated:** May 26, 2006
- **Primary specialty:** Pharmacy - Community/Retail Pharmacy · taxonomy 3336C0003X
- **Legal business name:** Albertsons Llc
- **Organization subpart:** No
- **Authorized official:** Kathy Giannakopoulos, ENROLLMENT MANAGER
## Practice location
- **Address:** 989 AVENIDA PICO, San Clemente, CA 92673-3908
- **Phone:** (949) 369-5596 · **Fax:** (949) 369-5691
## Record status
- **NPPES last updated:** August 1, 2023
- **Other identifiers:** Medicaid 071PHA477040 (CA); Medicaid 071PHA457770 (CA); Other 2000502
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1154377521) · Data from the CMS NPPES public registry.