SAV-ON PHARMACY #3174
NPI 1922055383
Pharmacy - Community/Retail Pharmacy in Ammon, ID

Q: What is Albertsons LLC's NPI number?

The NPI number for Albertsons LLC is 1922055383. It was assigned to this organization in the NPPES registry on May 30, 2006. The provider is doing business as Sav-On Pharmacy #3174.

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 April 3, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 30, 2006CLIA 13D1036189 · Waiver

1901 S 2500 E, AMMON, ID 83406(208) 524-1616(208) 528-6563 Get Directions Write a Review

NPPES record last updated: April 3, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 3, 2020, Oct 8, 2018, Aug 9, 2017 and 1 more (4 updates tracked since 2016).

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About Sav-on Pharmacy #3174 NPPES

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

SAV-ON PHARMACY #3174 (NPI 1922055383) is a healthcare organization registered as a community/retail pharmacy in Ammon, Idaho and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through January 23, 2027 and lists Kathy Giannakopoulos, Enrollment Manager, as its authorized official.

NPPES Registry Identity

NPI1922055383

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameALBERTSONS LLC

Location Address1901 S 2500 EAmmon, ID 83406

Mailing Address250 E Parkcenter BlvdBoise, ID 83706-3940

Phone(208) 524-1616

Fax(208) 528-6563

Organization SubpartNo

Authorized OfficialKathy GiannakopoulosEnrollment Manager · (208) 395-3954

Enumeration DateMay 30, 2006

Last NPPES UpdateApril 3, 20204 updates tracked since enumeration

NPPES CertifiedApril 3, 2020

✔ NPI 1922055383 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 · 21055RP

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

1901 S 2500 E, Ammon, ID 83406

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Other Names 1

Doing Business AsSav-on Pharmacy #3174

Other Identifiers 3

Other2021074Pk

Medicaid002256100ID

Medicaid807494800ID

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 13D1036189

Sav-On Pharmacy #3174 · Ammon, ID

Active · expires Jan 23, 2027

CLIA Number13D1036189

Laboratory TypePharmacy

Certificate Effective DateJanuary 24, 2025

Certificate Expiration DateJanuary 23, 2027

Laboratory DirectorTimothy Flynn

Laboratory Phone(208) 524-1616

Laboratory LocationSav-On Pharmacy #31741901 S 25th E, Ammon, ID 83406

CLIA data matches this NPI record on: 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 Sav-On Pharmacy #3174 carries, from the Medicare DMEPOS supplier directory.

Sav-On Pharmacy #3174

DMEPOS supplier · Ammon, IDOperated by Albertsons LLC

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Does not accept Medicare assignment

Sav-On Pharmacy #3174 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)20624429

Medicare Participant SinceJanuary 1, 2001

Supplier Location1901 S 25th EAmmon, ID 83406

Phone(208) 524-1616

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

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

GARY MONDELL RPH

Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)

1901 S 2500 E
AMMON, ID 83406

Bonneville County (208) 524-1616

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 1922055383. It was assigned to this organization in the NPPES registry on May 30, 2006. The provider is doing business as Sav-On Pharmacy #3174.

Where is Albertsons LLC located?

Albertsons LLC is located at 1901 S 2500 E, Ammon, ID 83406. The listed phone number is (208) 524-1616.

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, Sav-On Pharmacy #3174 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 13D1036189) is associated with this NPI, valid through January 23, 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 Arizona Complete Health and Ambetter from Arkansas Health & Wellness and 42 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.