NPI | 1144259193 |
---|---|
Doing Business As | VONS PHARMACY #2858 |
Entity Type | Organization |
Authorized Contact | DEMOND HAWKINS Third Party Manager 208-395-3905 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY52110) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
333600000X Pharmacy | |
Enumeration Date | 2006-07-02 |
Last Update Date | 2018-07-19 |