Vons Companies Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY52348 Issued in CA

Legal business name

VONS COMPANIES INC

Doing business as

Vons Pharmacy #2131

Practice address

12199 Hesperia Rd
Victorville, CA 92395-4756

Phone

(760) 241-8384

Fax

(760) 843-0378

NPI assigned

Jun 21, 2006

Last updated

Nov 1, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tiffany Eliopulos

Title

Assistant Manager, Enrollments

Phone

(208) 395-3906

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• VONS PHARMACY #2131 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Safeway Inc

  dba Safeway Phamracy #4837

  • Community/Retail Pharmacy
  • District Heights, MD
  • NPI 1588600191

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen Eugene Bottorff, RPH

  • Pharmacist
  • Victorville, CA
  • NPI 1093084790
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541030400000",
    "number": "1356387963",
    "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": "12199 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954756",
            "telephone_number": "760-241-8384",
            "fax_number": "760-843-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VONS COMPANIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-11-01",
        "status": "A",
        "authorized_official_last_name": "ELIOPULOS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "ASSISTANT MANAGER, ENROLLMENTS",
        "authorized_official_telephone_number": "208-395-3906"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY52348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356387963",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2000212",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VONS PHARMACY #2131",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VONS PHARMACY #2131",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vista Guidance Centers, Inc.
• Thuy T Vo, PHARM D.
• Adam Vollandt
• Irene Vong
• Marsha Vonlinsowe
• Vvipa Medical Group Inc (Heritage Victor Valley Medical Group)
• Brittany Michelle Wagner
• Jessica Waite
• Wal-Mart Stores, Inc (Wal-Mart Vision Center 30-4392)
• Wal-Mart Stores, Inc. (Vision Center 30-1588)

• Community/Retail Pharmacy in Victorville, CA
• Providers in Victorville, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.

Verify at the official NPI Registry.