Organization
SHAWS SUPERMARKETS INC
Active
Parent organization
SUPERVALU INC
Other names
OSCO PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUPERVALU INC
Authorized official
MR. LORENZO TORRES III (NEW STORE ENROLLMENTS)
(847) 916-4463
Entity
Organization
Contact information
Practice address
320 WARWICK AVE, WARWICK, RI 02888-1300
(401) 785-3987
(401) 785-4608
Mailing address
320 WARWICK AVE, WARWICK, RI 02888-1300
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHA00352
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4106010
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
SS29955
—
RI
Enumeration date
05/25/2006
Last updated
12/07/2007
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