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Organization
VONS COMPANIES INC
Active
Organization
VONS COMPANIES INC
Active
Other names
VONS PHARMACY #1623
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
4001 INGLEWOOD AVE, REDONDO BEACH, CA 90278-1121
(310) 349-0863
(310) 349-0878
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC 2-B, BOISE, ID 83706-3940
(208) 395-6200
(623) 282-3834
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY52257
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699711200
—
CA
01
—
2065147
PK
—
Enumeration date
06/21/2006
Last updated
10/29/2018
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