ALBERTSONS MARKET PHARMACY #678 – Community/Retail Pharmacy, NPI 1164460523

ALBERTSONS MARKET PHARMACY #678 is a healthcare provider. based in San angelo, Texas. specializing in Community/Retail Pharmacy. The organization holds a License No. 29330 (TX). The NPI Number for ALBERTSONS MARKET PHARMACY #678 is 1164460523

Main info

Organization
Name
ALBERTSONS MARKET PHARMACY #678
NPI
1164460523
Phone
(325) 942-6658
Address
3121 SUNSET DR
Authorized Official
KATHY GIANNAKOPOULOS ENROLLMENTS MANAGER
Enumeration Date
4 June 2006
Last Update Date
18 March 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness90
Years active:20State licenses:1Digital endpoints

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Provider Addresses for ALBERTSONS MARKET PHARMACY #678

  • Market Street, 3121, Sunset Drive, Vista del Arroyo, San Angelo, Tom Green County, Texas, 76904, United States

    SAN ANGELO, TX 769046501

    Phone: (325) 942-6658

    Fax: (325) 949-6654

    Type: Location

  • Orlando Avenue, Lubbock, Texas, 79416, United States

    LUBBOCK, TX 794231942

    Phone: (806) 791-8113

    Fax: (806) 791-7490

    Type: Mailing

  • 250 E PARKCENTER BLVD

    BOISE, ID 837063940

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-10-01

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-09-30 (623 days ago).

Enrollment records

1

Earliest due date

2024-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20151001002585OPharmacyTX2024-09-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76904)

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Reviews

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Frequently asked questions

What number should I use to identify ALBERTSONS MARKET PHARMACY #678 for billing?
Administrative and clinical systems typically use NPI 1164460523 for ALBERTSONS MARKET PHARMACY #678.
Should I treat ALBERTSONS MARKET PHARMACY #678 as an active provider?
Patients and plans typically see ALBERTSONS MARKET PHARMACY #678 as active in the national extract.
What type of care does ALBERTSONS MARKET PHARMACY #678 provide?
ALBERTSONS MARKET PHARMACY #678's profile centers on Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Is ALBERTSONS MARKET PHARMACY #678 tied to San Angelo, Texas?
If you are local to San Angelo, Texas, ALBERTSONS MARKET PHARMACY #678 may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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