Organization
VONS COMPANIES INC
Active
Other names
VONS PHARMACY #1963
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
1155 E TWAIN AVE, LAS VEGAS, NV 89169-4208
(702) 696-1481
(702) 696-9873
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC 2-B, BOISE, ID 83706-3940
(208) 395-3920
(623) 282-3834
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH01647
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100500306
—
NV
05
—
1548206170
—
NV
01
—
2056122
PK
—
Enumeration date
06/21/2006
Last updated
11/01/2018
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