Provider Demographics
NPI:1598794547
Name:VONS COMPANIES INC
Entity Type:Organization
Organization Name:VONS COMPANIES INC
Other - Org Name:VONS PHARMACY #2353
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGED CARE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RRITA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-467-2811
Mailing Address - Street 1:5918 STONERIDGE MALL RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3229
Mailing Address - Country:US
Mailing Address - Phone:925-467-2806
Mailing Address - Fax:925-467-2802
Practice Address - Street 1:933 SWEETWATER RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-4837
Practice Address - Country:US
Practice Address - Phone:619-460-6336
Practice Address - Fax:619-460-0287
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAFEWAY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-02
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY43016332B00000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0595047OtherOTHER ID NUMBER-COMMERCIAL NUMBER
CAPHA430160Medicaid
CA1115530032Medicare NSC
CAPHA430160Medicaid
CAP00229894Medicare PIN