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VONS PHARMACY #2053
NPI 1154350106
Pharmacy - Community/Retail Pharmacy in San Diego, CA

Active since July 02, 2006CLIA 05D1067902 · Waiver
3645 MIDWAY DR, SAN DIEGO, CA 92110(619) 222-9736(619) 222-9035 Get Directions Write a Review

NPPES record last updated: November 1, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 1, 2018, Jul 19, 2018, Oct 14, 2016 (3 updates tracked since 2016).

About Vons Pharmacy #2053 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VONS PHARMACY #2053 (NPI 1154350106) is a healthcare organization registered as a community/retail pharmacy in San Diego, California and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through April 26, 2027 and lists Tiffany Eliopulos, Assistant Manager, Enrollments, as its authorized official.

NPPES Registry Identity

NPI1154350106
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameVONS COMPANIES INC
Location Address3645 MIDWAY DRSan Diego, CA 92110-5202
Mailing Address250 E Parkcenter Blvd, Mailstop Sec 2-bBoise, ID 83706-3940 · (208) 395-6200 · Fax (623) 282-3834
Phone(619) 222-9736
Fax(619) 222-9035
Organization SubpartNo
Authorized OfficialTiffany EliopulosAssistant Manager, Enrollments · (208) 395-3906
Enumeration DateJuly 2, 2006
Last NPPES UpdateNovember 1, 20183 updates tracked since enumeration
✔ NPI 1154350106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in CA · PHY52282
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
3645 MIDWAY DR, San Diego, CA 92110
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Other Names 1

Doing Business AsVons Pharmacy #2053

Other Identifiers 2

Medicaid1154350106CA
Other1999495Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1067902

Vons Pharmacy #2053 · San Diego, CA
Active · expires Apr 26, 2027
CLIA Number05D1067902
Laboratory TypePharmacy
Certificate Effective DateApril 27, 2025
Certificate Expiration DateApril 26, 2027
Laboratory DirectorNathan C. Ramsey
Laboratory Phone(619) 222-9736
Laboratory LocationVons Pharmacy #20533645 Midway Drive, San Diego, CA 92110
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Vons Pharmacy #2053 carries, from the Medicare DMEPOS supplier directory.

Vons Pharmacy #2053

DMEPOS supplier · San Diego, CAOperated by Vons Companies Inc
⋮

Does not accept Medicare assignment

Vons Pharmacy #2053 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20465999
Medicare Participant SinceJanuary 1, 2017
Supplier Location3645 Midway DrSan Diego, CA 92110
Phone(619) 222-9736
Supplier Specialties
Pharmacy Grocery Store

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RANDY SAYURIN JIMENEZ
Pharmacist
3645 MIDWAY DR
SAN DIEGO, CA 92110
San Diego County (619) 222-9736
BERNICE HAUTH
Pharmacist
3645 MIDWAY DR
SAN DIEGO, CA 92110
San Diego County (619) 222-9736

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vons Companies Inc's NPI number?

The NPI number for Vons Companies Inc is 1154350106. It was assigned to this organization in the NPPES registry on July 2, 2006. The provider is doing business as Vons Pharmacy #2053.

Where is Vons Companies Inc located?

Vons Companies Inc is located at 3645 Midway Dr, San Diego, CA 92110. The listed phone number is (619) 222-9736.

What is Vons Companies Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Vons Companies Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Vons Pharmacy #2053 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Vons Companies Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1067902) is associated with this NPI, valid through April 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Vons Companies Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Arizona Complete Health and Ambetter from Arkansas Health & Wellness and 41 other insurers list Vons Companies Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Vons Companies Inc was last updated on November 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.