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Organization
VONS COMPANIES INC
Active
Organization
VONS COMPANIES INC
Active
Other names
Pavilions Pharmacy #2784
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
515 W WASHINGTON ST, SAN DIEGO, CA 92103-1986
(619) 299-0079
(619) 299-0762
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC 2-B, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY52132
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184997835
—
CA
01
—
2133792
PK
—
Enumeration date
02/10/2012
Last updated
03/22/2025
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