Organization
THE VON'S COMPANIES
Active
Parent organization
SAFEWAY INC
Other names
VONS PHARMACY #4196
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAFEWAY INC
Authorized official
MICHELLE ANN RIVERS CPHT (MANAGED CARE PLAN SPECIALIST)
(623) 869-3524
Entity
Organization
Contact information
Practice address
3325 E RUSSELL RD, LAS VEGAS, NV 89120-3470
(702) 454-5521
(702) 454-0924
Mailing address
20427 N 27TH AVE # MSC4551, PHOENIX, AZ 85027-3241
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH1172
NV
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2802675
—
NV
01
—
2903676
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/21/2006
Last updated
11/18/2008
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