Organization
NEW ALBERTSON'S INC #7557/490
Active
Parent organization
NEW ALBERTSON'S INC
Other names
Shaws Osco Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW ALBERTSON'S INC
Authorized official
MICHAEL IVAN BOUDREAU RPH (STAFF PHARMACIST)
(207) 669-3005
Entity
Organization
Contact information
Practice address
175 HIGH ST, ELLSWORTH, ME 04605-1730
(207) 669-3005
(207) 669-3013
Mailing address
175 HIGH ST, ELLSWORTH, ME 04605-1730
(207) 669-3005
(207) 669-3013
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PR4615
ME
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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