Organization
SHAWS SUPERMARKETS INC
Active
Other names
Osco Pharmacy #2527
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
213 MAIN ST, LUDLOW, VT 05149-1009
(802) 228-2402
(802) 419-6276
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/01/2024
Last updated
05/07/2024
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