Active NPI
Vons Companies Inc
- Community/Retail Pharmacy
- Pasadena, CA
National Provider Identifier
1144259193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY52110
- Legal business name
- VONS COMPANIES INC
- Practice address
- 2355 E Colorado Blvd
Pasadena, CA 91107-3644 - Phone
- (626) 744-2619
- Fax
- (626) 744-2630
- NPI assigned
- Jul 2, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Demond Hawkins
- Title
- Third Party Manager
- Phone
- (208) 395-3905
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY52110 | CA | Primary |
Addresses
Primary practice location
2355 E Colorado Blvd
Pasadena, CA 91107-3644
Mailing address
250 E Parkcenter Blvd
Mailstop Sec 2-B
Boise, ID 83706-3940
Phone (208) 395-6200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1999971 | Other | PK | |
| 1144259193 | Medicaid | CA |
Other names 1
- VONS PHARMACY #2858
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040831001282 | TX | Part B Supplier - Centralized Flu Biller | 2961314463 |
This NPI is an additional NPI on the enrollment Practice locations: Boise, ID |
| O20100930028202 | CA | DME Supplier - Pharmacy | 2961314463 | Practice locations: Pasadena, CA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2065766 | Vons Pharmacy # 2858 | Certificate of waiver | Dec 13, 2026 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Vons Pharmacy #2858 | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Surgical Dressings | Does not accept assignment |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Pasadena, CA
- NPI 1841804564
-
- Pharmacist
- Pasadena, CA
- NPI 1457943953
-
- Pharmacist
- Pasadena, CA
- NPI 1730858259
-
- Pharmacist
- Pasadena, CA
- NPI 1306507934
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1531958400000",
"number": "1144259193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 E PARKCENTER BLVD",
"address_2": "MAILSTOP SEC 2-B",
"city": "BOISE",
"state": "ID",
"postal_code": "837063940",
"telephone_number": "208-395-6200",
"fax_number": "623-282-3834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2355 E COLORADO BLVD",
"city": "PASADENA",
"state": "CA",
"postal_code": "911073644",
"telephone_number": "626-744-2619",
"fax_number": "626-744-2630"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VONS COMPANIES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-02",
"last_updated": "2018-07-19",
"status": "A",
"authorized_official_last_name": "HAWKINS",
"authorized_official_first_name": "DEMOND",
"authorized_official_title_or_position": "THIRD PARTY MANAGER",
"authorized_official_telephone_number": "208-395-3905"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "PHY52110",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "1999971",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1144259193",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "VONS PHARMACY #2858",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "VONS PHARMACY #2858",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.