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Organization
VONS COMPANIES INC
Active
Organization
VONS COMPANIES INC
Active
Other names
VONS PHARMACY #2306
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
3900 BROAD ST, SAN LUIS OBISPO, CA 93401-7015
(805) 541-1132
(805) 543-7469
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
PHY52131
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790714731
—
CA
01
—
2001172
PK
—
Enumeration date
07/02/2006
Last updated
11/01/2018
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