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Organization
VONS COMPANIES INC
Active
Organization
VONS COMPANIES INC
Active
Other names
VONS PHARMACY #2832
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
1600 FOOTHILL BLVD, LA VERNE, CA 91750-3436
(909) 593-2592
(909) 392-4513
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
PHY52114
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770756488
—
CA
01
—
2113313
PK
—
Enumeration date
04/03/2008
Last updated
10/05/2018
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