# SHAWS SUPERMARKETS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shaws Pharmacy \#1414
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184670614
- **Authorized official:** TIFFANY ELIOPULOS (ENROLLMENT ASSISTANT MANAGER)
- **Authorized official phone:** (208) 395-3906

## Contact information

- **Practice address:** 230 MAIN ST, MEDFIELD, MA 02052
- **Practice address phone:** (508) 359-6855
- **Practice address fax:** (508) 359-7519
- **Mailing address:** 250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
- **Mailing address phone:** (208) 395-6200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | DS3317 | MA | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 07/03/2024