NPIMap

Organization Active NPI

Vons Companies Inc

  • Community/Retail Pharmacy
  • Carlsbad, CA
National Provider Identifier
1790189223
Registry record updated Mar 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY53419 Issued in CA
Legal business name
VONS COMPANIES INC
Practice address
3439 Via Montebello
Carlsbad, CA 92009-8487
Phone
(760) 633-0168
Fax
(760) 633-0192
NPI assigned
Oct 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2025

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 PHY53419 CA Primary

Addresses

Primary practice location

3439 Via Montebello
Carlsbad, CA 92009-8487

Mailing address

250 E Parkcenter Blvd
Mailstop Sec 2-B
Boise, ID 83706-3940

Other identifiers 2

IdentifierTypeStateIssuer
2148387OtherPK
1790189223MedicaidCA

Other names 1

  • Pavilions Pharmacy #2724 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150203000692 CA DME Supplier - PharmacyDME Supplier - Grocery Store 2961314463 Practice locations: Carlsbad, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2105341Pavilions Pharmacy #27243439 Via Montebello, Carlsbad, CA 92009Certificate of waiverDec 12, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pavilions Pharmacy #27243439 Via Montebello, Carlsbad, CA 92009-8487(760) 633-0168 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 2017

National Provider Directory

National Provider Directory
Tax ID family
Expo Pharmacy 60010 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the 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": "1413158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742601600000",
    "number": "1790189223",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3439 VIA MONTEBELLO",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920098487",
            "telephone_number": "760-633-0168",
            "fax_number": "760-633-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VONS COMPANIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-13",
        "last_updated": "2025-03-22",
        "certification_date": "2025-03-21",
        "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": "CA",
            "license": "PHY53419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148387",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790189223",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pavilions Pharmacy #2724",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pavilions Pharmacy #2724",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2025; 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.