Healthcare Provider Details

I. General information

NPI: 1598794547
Provider Name (Legal Business Name): VONS COMPANIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 SWEETWATER RD
SPRING VALLEY CA
91977-4837
US

IV. Provider business mailing address

5918 STONERIDGE MALL RD
PLEASANTON CA
94588-3229
US

V. Phone/Fax

Practice location:
  • Phone: 619-460-6336
  • Fax: 619-460-0287
Mailing address:
  • Phone: 925-467-2806
  • Fax: 925-467-2802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPHY43016
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RRITA CALARA
Title or Position: MANAGED CARE SPECIALIST
Credential:
Phone: 925-467-2811