Vons Companies Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY52213 Issued in CA

Legal business name

VONS COMPANIES INC

Doing business as

Vons Pharmacy #2162

Practice address

1440 W 25TH St
San Pedro, CA 90732-4418

Phone

(310) 832-0319

Fax

(310) 832-1142

NPI assigned

Jul 2, 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 #2162 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, CA2 enrollments

Enrollment records 2

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

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541030400000",
    "number": "1487683413",
    "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": "1440 W 25TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907324418",
            "telephone_number": "310-832-0319",
            "fax_number": "310-832-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VONS COMPANIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "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": "PHY52213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2000511",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487683413",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VONS PHARMACY #2162",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VONS PHARMACY #2162",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vital Health Med Group Inc (Breathe Total Balance)
• Janet Aurora Vivero, PH.D.
• Rebecca Thi Vo, RN
• Volunteers of America of Los Angeles
• Volunteers of America of Los Angeles
• Vons Companies Inc (Vons Pharmacy #2283)
• Tiffany Marie Vrcic, RD
• Aleksandar Vukotic, D.D.S.
• Genesa Wagoner, M.D.
• Elizabeth Messiha Wahba

• Community/Retail Pharmacy in San Pedro, CA
• Providers in San Pedro, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.