Active NPI
The Von'S Companies
- Community/Retail Pharmacy
- Las Vegas, NV
National Provider Identifier
1619906641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- THE VON'S COMPANIES
- Practice address
- 4854 W Lone Mountain Rd
Las Vegas, NV 89130-2239 - Phone
- (702) 656-1484
- Fax
- (702) 645-1151
- NPI assigned
- Jul 2, 2006
- Organization subpart
- Yes
- Parent organization
- SAFEWAY INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle Ann Rivers, CPHT
- Title
- Managed Care Plan Specialist
- Phone
- (623) 869-3524
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PH1175 | NV | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
4854 W Lone Mountain Rd
Las Vegas, NV 89130-2239
Mailing address
20427 N 27TH Ave # Msc4551
Phoenix, AZ 85027-3241
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2905098 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 2802668 | Medicaid | NV |
Other names 1
- VONS PHARMACY #2393
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| 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 |
National Provider Directory
National Provider Directory- Part of
- Safeway Pharmacy 1073
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
4854 W Lone Mountain Rd
Las Vegas, NV 89130
Phone (702) 656-1484
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": "1226880000000",
"number": "1619906641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20427 N 27TH AVE # MSC4551",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850273241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4854 W LONE MOUNTAIN RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891302239",
"telephone_number": "702-656-1484",
"fax_number": "702-645-1151"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE VON'S COMPANIES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SAFEWAY INC",
"enumeration_date": "2006-07-02",
"last_updated": "2008-11-17",
"status": "A",
"authorized_official_last_name": "RIVERS",
"authorized_official_first_name": "MICHELLE",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "MANAGED CARE PLAN SPECIALIST",
"authorized_official_telephone_number": "623-869-3524",
"authorized_official_credential": "CPHT"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NV",
"license": "PH1175",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "2905098",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2802668",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "VONS PHARMACY #2393",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; 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.