# SHAWS SUPERMARKETS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Osco Pharmacy \#2527
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255182622
- **Authorized official:** KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
- **Authorized official phone:** (208) 395-3954

## Contact information

- **Practice address:** 213 MAIN ST, LUDLOW, VT 05149-1009
- **Practice address phone:** (802) 228-2402
- **Practice address fax:** (802) 419-6276
- **Mailing address:** 250 E PARKCENTER BLVD, BOISE, ID 83706-3940

## Taxonomy

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

## Other

- **Enumeration date:** 04/01/2024
- **Last updated:** 05/07/2024