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PAVILIONS PHARMACY #2228
NPI 1962431916
Pharmacy - Community/Retail Pharmacy in South Pasadena, CA

Active since July 02, 2006CLIA 05D2070908 · Waiver
1213 FAIR OAKS AVE, SOUTH PASADENA, CA 91030(626) 799-4156(626) 799-7391 Get Directions Write a Review

NPPES record last updated: November 1, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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

About Pavilions Pharmacy #2228 NPPES

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

PAVILIONS PHARMACY #2228 (NPI 1962431916) is a healthcare organization registered as a community/retail pharmacy in South Pasadena, California and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through February 7, 2027 and lists Tiffany Eliopulos, Assistant Manager, Enrollments, as its authorized official.

NPPES Registry Identity

NPI1962431916
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameVONS COMPANIES INC
Location Address1213 FAIR OAKS AVESouth Pasadena, CA 91030-3805
Mailing Address250 E Parkcenter Blvd, Mailstop Sec 2-bBoise, ID 83706-3940 · (208) 395-6200 · Fax (623) 282-3834
Phone(626) 799-4156
Fax(626) 799-7391
Organization SubpartNo
Authorized OfficialTiffany EliopulosAssistant Manager, Enrollments · (208) 395-3906
Enumeration DateJuly 2, 2006
Last NPPES UpdateNovember 1, 20183 updates tracked since enumeration
✔ NPI 1962431916 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 · PHY52188
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
1213 FAIR OAKS AVE, South Pasadena, CA 91030
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Other Names 1

Doing Business AsPavilions Pharmacy #2228

Other Identifiers 2

Other1999972Pk
Medicaid1962431916CA

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 05D2070908

Pavillions Pharmacy # 2228 · South Pasadena, CA
Active · expires Feb 7, 2027
CLIA Number05D2070908
Laboratory TypePharmacy
Certificate Effective DateFebruary 8, 2025
Certificate Expiration DateFebruary 7, 2027
Laboratory DirectorMary Anne R. Jose-Nam
Laboratory Phone(626) 799-4156
Laboratory LocationPavillions Pharmacy # 22281213 Fair Oaks Avenue, South Pasadena, CA 91030
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Pavilions Pharmacy #2228 carries, from the Medicare DMEPOS supplier directory.

Pavilions Pharmacy #2228

DMEPOS supplier · South Pasadena, CAOperated by Vons Companies Inc
⋮

Does not accept Medicare assignment

Pavilions Pharmacy #2228 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)20467085
Medicare Participant SinceJanuary 1, 2017
Supplier Location1213 Fair Oaks AveSouth Pasadena, CA 91030
Phone(626) 799-4156
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 3

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

MRS. MARGARET M WU
Pharmacist
1213 FAIR OAKS AVE
SOUTH PASADENA, CA 91030
Los Angeles County (626) 799-4156
ROY ISAMU MIYASHIRO PHARM D
Pharmacist
1213 FAIR OAKS AVE
SOUTH PASADENA, CA 91030
Los Angeles County (626) 799-4156
DAVID FONG PHARM. D.
Pharmacist
1213 FAIR OAKS AVE
SOUTH PASADENA, CA 91030
Los Angeles County (626) 799-4156

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 1962431916. It was assigned to this organization in the NPPES registry on July 2, 2006. The provider is doing business as Pavilions Pharmacy #2228.

Where is Vons Companies Inc located?

Vons Companies Inc is located at 1213 Fair Oaks Ave, South Pasadena, CA 91030. The listed phone number is (626) 799-4156.

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, Pavilions Pharmacy #2228 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 05D2070908) is associated with this NPI, valid through February 7, 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.