Organization
SHAWS SUPERMARKETS INC
Active
Parent organization
SUPERVALU INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUPERVALU INC
Authorized official
DEMOND HAWKINS (THIRD PARTY MANAGER)
(208) 395-3905
Entity
Organization
Contact information
Practice address
8 CHAPEL VIEW BLVD, CRANSTON, RI 02905
(401) 464-9181
(401) 464-9154
Mailing address
8 CHAPEL VIEW BLVD, CRANSTON, RI 02905
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHA00360
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4106399
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
SS57302
—
RI
Enumeration date
05/25/2006
Last updated
01/23/2018
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