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General NPI Number Information
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NPI Number | 1750726303
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Entity Type | Organization
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Legal Business Name | VONS PHARMACY #6770
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 618 MICHILLINDA AVENUE, 3RD FLOOR
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City | ARCADIA
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State | CA
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Zip | 91007
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Country | US
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Telephone | 626-821-7726
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Fax | 623-869-1270
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Provider Business Mailing Address
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Address Line | 618 MICHILLINDA AVENUE, 3RD FLOOR
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City | ARCADIA
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State | CA
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Zip | 91007
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Country | US
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Telephone | 626-821-7726
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Fax | 623-869-1270
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Authorized Official
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Title or Position | V.P. PHARMACY
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Name | PAUL KNERR
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Credential | PHARMACIST
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Telephone | 626-821-7726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY51070
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License Number State | CA
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