Organization
SHAWS SUPERMARKETS INC
Active
Other names
Shaws Pharmacy #2535
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3932
Entity
Organization
Contact information
Practice address
15 FOREST ST, WOODSVILLE, NH 03785
(603) 747-5003
(603) 747-5006
Mailing address
250 E PARKCENTER BLVD, SEC2-B, BOISE, ID 83706-3940
(208) 395-6200
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
04365
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031903
—
VT
01
—
2171812
PK
—
05
—
3111366
—
NH
Enumeration date
09/26/2017
Last updated
07/10/2024
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