Organization Active NPI

Vons Companies Inc

  • Community/Retail Pharmacy
  • Henderson, NV
National Provider Identifier
1386680148
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH01178 Issued in NV
Legal business name
VONS COMPANIES INC
Practice address
2667 Windmill Pkwy
Henderson, NV 89074-3384
Phone
(702) 361-1157
Fax
(702) 361-0642
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Authorized official

Name
Kathy Giannakopoulos
Title
Enrollments Manager
Phone
(208) 395-3954

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH01178 NV Primary

Addresses

Primary practice location

2667 Windmill Pkwy
Henderson, NV 89074-3384

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other identifiers 2

IdentifierTypeStateIssuer
2802679MedicaidNV
2056845OtherPK

Other names 1

  • VONS PHARMACY #2511 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040831001282 TX Part B Supplier - Centralized Flu Biller 2961314463 This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID
O20100930015736 NV DME Supplier - PharmacyDME Supplier - Grocery Store 2961314463 Practice locations: Henderson, NV

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1386680148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2667 WINDMILL PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890743384",
            "telephone_number": "702-361-1157",
            "fax_number": "702-361-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VONS COMPANIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "GIANNAKOPOULOS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ENROLLMENTS MANAGER",
        "authorized_official_telephone_number": "208-395-3954"
    },
    "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": "NV",
            "license": "PH01178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2802679",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2056845",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VONS PHARMACY #2511",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VONS PHARMACY #2511",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.