Organization
VONS COMPANIES INC
Active
Other names
VONS PHARMACY #2615
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
45 E HORIZON RIDGE PKWY, HENDERSON, NV 89002-7908
(702) 564-1425
(702) 564-8545
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
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH02102
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100509268
—
NV
01
—
2052132
PK
—
Enumeration date
07/02/2006
Last updated
10/04/2018
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