Organization Active NPI

The Von'S Companies

  • Community/Retail Pharmacy
  • Las Vegas, NV
National Provider Identifier
1619906641
Registry record updated Nov 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
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 INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2008

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2905098OtherOTHER ID NUMBER-COMMERCIAL NUMBER
2802668MedicaidNV

Other names 1

  • VONS PHARMACY #2393 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

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

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.

Verify at the official NPI Registry.