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ALBERTSONS PHARMACY #0025
NPI 1396113510
Pharmacy - Community/Retail Pharmacy in Phoenix, AZ

Active since September 03, 2015CLIA 03D2109239 · Waiver
21001 N TATUM BLVD STE 76, PHOENIX, AZ 85050(480) 585-1510(480) 585-1986 Get Directions Write a Review

NPPES record last updated: April 1, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 1, 2020, Sep 11, 2018, May 10, 2018 and 5 more (8 updates tracked since 2015).

About Albertsons Pharmacy #0025 NPPES

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

ALBERTSONS PHARMACY #0025 (NPI 1396113510) is a healthcare organization registered as a community/retail pharmacy in Phoenix, Arizona and active in the NPI registry since September 2015. The organization holds a CLIA Waiver certificate valid through February 21, 2028 and lists Kathy Giannakopoulos, Enrollment Manager, as its authorized official.

NPPES Registry Identity

NPI1396113510
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameALBERTSONS LLC
Location Address21001 N TATUM BLVD STE 76Phoenix, AZ 85050-4239
Mailing Address250 E Parkcenter BlvdBoise, ID 83706-3940
Phone(480) 585-1510
Fax(480) 585-1986
Organization SubpartNo
Authorized OfficialKathy GiannakopoulosEnrollment Manager · (208) 395-3954
Enumeration DateSeptember 3, 2015
Last NPPES UpdateApril 1, 20208 updates tracked since enumeration
NPPES CertifiedApril 1, 2020
✔ NPI 1396113510 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 AZ · Y006542
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
21001 N TATUM BLVD STE 76, Phoenix, AZ 85050
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Other Names 1

Doing Business AsAlbertsons Pharmacy #0025

Other Identifiers 2

Medicaid106818AZ
Other2156073Pk

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 03D2109239

Albertsons Pharmacy #0025 · Phoenix, AZ
Active · expires Feb 21, 2028
CLIA Number03D2109239
Laboratory TypePharmacy
Certificate Effective DateFebruary 22, 2026
Certificate Expiration DateFebruary 21, 2028
Laboratory DirectorNeil Coronado
Laboratory Phone(480) 585-1510
Laboratory LocationAlbertsons Pharmacy #002521001 N Tatum Blvd Ste 76, Phoenix, AZ 85050
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 Albertson's Pharmacy #0025 carries, from the Medicare DMEPOS supplier directory.

Albertson's Pharmacy #0025

DMEPOS supplier · Phoenix, AZOperated by Albertsons LLC
⋮

Does not accept Medicare assignment

Albertson's Pharmacy #0025 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)20621507
Medicare Participant SinceJanuary 1, 2001
Supplier Location21001 N Tatum Blvd Ste 76Phoenix, AZ 85050
Phone(480) 585-1510
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 2

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

AJNA NASIC
Pharmacist
21001 N TATUM BLVD STE 76
PHOENIX, AZ 85050
Maricopa County (480) 342-8231
1918 WINTER STREET OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
21001 N TATUM BLVD STE 76
PHOENIX, AZ 85050
Maricopa County (480) 585-1510

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 1396113510. It was assigned to this organization in the NPPES registry on September 3, 2015. The provider is doing business as Albertsons Pharmacy #0025.

Where is Albertsons LLC located?

Albertsons LLC is located at 21001 N Tatum Blvd Ste 76, Phoenix, AZ 85050. The listed phone number is (480) 585-1510.

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 #0025 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 03D2109239) is associated with this NPI, valid through February 21, 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 43 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 1, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.