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ALBERTSONS PHARMACY #1708
NPI 1235516600
Pharmacy - Community/Retail Pharmacy in Salt Lake City, UT

Active since May 05, 2015CLIA 46D2146689 · Waiver
729 N REDWOOD RD, SALT LAKE CITY, UT 84116(801) 532-3795(801) 532-4909 Get Directions Write a Review

NPPES record last updated: April 3, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 3, 2020, Nov 1, 2018, Jun 29, 2016 and 1 more (4 updates tracked since 2016).

About Albertsons Pharmacy #1708 NPPES

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

ALBERTSONS PHARMACY #1708 (NPI 1235516600) is a healthcare organization registered as a community/retail pharmacy in Salt Lake City, Utah and active in the NPI registry since May 2015. The organization holds a CLIA Waiver certificate valid through April 3, 2028 and lists Kathy Giannakopoulos, Enrollment Manager, as its authorized official.

NPPES Registry Identity

NPI1235516600
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameALBERTSONS LLC
Location Address729 N REDWOOD RDSalt Lake City, UT 84116-1909
Mailing Address250 E Parkcenter BlvdBoise, ID 83706-3940
Phone(801) 532-3795
Fax(801) 532-4909
Organization SubpartNo
Authorized OfficialKathy GiannakopoulosEnrollment Manager · (208) 395-3954
Enumeration DateMay 5, 2015
Last NPPES UpdateApril 3, 20204 updates tracked since enumeration
NPPES CertifiedApril 3, 2020
✔ NPI 1235516600 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in UT · 9404145-1703
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
729 N REDWOOD RD, Salt Lake City, UT 84116
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Other Names 1

Doing Business AsAlbertsons Pharmacy #1708

Other Identifiers 2

Other2151908Pk
Medicaid1235516600UT

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 46D2146689

Albertsons Pharmacy #1708 · Salt Lake City, UT
Active · expires Apr 3, 2028
CLIA Number46D2146689
Laboratory TypePharmacy
Certificate Effective DateApril 4, 2026
Certificate Expiration DateApril 3, 2028
Laboratory DirectorKelli Thorup
Laboratory Phone(801) 532-3795
Laboratory LocationAlbertsons Pharmacy #1708729 N Redwood Rd, Salt Lake City, UT 84116
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 12

Medicare supplier enrollment and the product categories Albertson's Pharmacy #1708 carries, from the Medicare DMEPOS supplier directory.

Albertson's Pharmacy #1708

DMEPOS supplier · Salt Lake City, UTOperated by Albertsons LLC
⋮

Does not accept Medicare assignment

Albertson's Pharmacy #1708 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)20624963
Medicare Participant SinceJanuary 1, 2001
Supplier Location729 N Redwood RdSalt Lake City, UT 84116
Phone(801) 532-3795
Supplier Specialties
Pharmacy

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 3

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

BRENDA LEE WALLER
Pharmacy Technician
729 N REDWOOD RD
SALT LAKE CITY, UT 84116
Salt Lake County (801) 532-3795
1918 WINTER STREET OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
729 N REDWOOD RD
SALT LAKE CITY, UT 84116
Salt Lake County (801) 532-3795
MICHAEL LEWIS TYLER PHARMD
Pharmacist
729 N REDWOOD RD
SALT LAKE CITY, UT 84116
Salt Lake County (801) 364-7390

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 1235516600. It was assigned to this organization in the NPPES registry on May 5, 2015.

Where is Albertsons LLC located?

Albertsons LLC is located at 729 N Redwood Rd, Salt Lake City, UT 84116. The listed phone number is (801) 532-3795.

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, Albertson's Pharmacy #1708 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 46D2146689) is associated with this NPI, valid through April 3, 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 44 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 April 3, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.