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Organization
SHAWS SUPERMARKETS INC
Active
Organization
SHAWS SUPERMARKETS INC
Active
Other names
Shaws Pharmacy #4443
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3932
Entity
Organization
Contact information
Practice address
15 SMITHFIELD RD, NORTH PROVIDENCE, RI 02904
(401) 353-4075
(401) 353-9614
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
CPHA00548
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2089153
PK
—
05
—
SS13102
—
RI
Enumeration date
05/25/2006
Last updated
07/09/2024
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