# SHAWS SUPERMARKETS INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Shaws Pharmacy \#0616
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598705782
- **Authorized official:** KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
- **Authorized official phone:** (208) 395-3932

## Contact information

- **Practice address:** 160 PAINE TPKE N, BERLIN, VT 05602
- **Practice address phone:** (802) 223-8599
- **Practice address fax:** (802) 223-8598
- **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 | 038.0093607 | VT | Yes |

## Other

- **Enumeration date:** 06/07/2006
- **Last updated:** 07/10/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1007543 | — | VT |
| 01 | — | 2101656 | PK | — |