Organization
VONS COMPANIES INC
Active
Other names
VONS PHARMACY #2390
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
475 E WINDMILL LN, LAS VEGAS, NV 89123-1808
(702) 896-7414
(702) 896-4614
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH01147
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2050923
PK
—
05
—
2802997
—
NV
Enumeration date
07/02/2006
Last updated
06/22/2020
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