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Organization

SHAWS SUPERMARKETS INC

Active
Other names
Shaws Pharmacy #0686
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3932
Entity
Organization

Contact information

Practice address
43 INDIAN ROCK RD, WINDHAM, NH 03087
(603) 437-3481
(603) 437-2678
Mailing address
250 E PARKCENTER BLVD, MAILSTOP 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
0677P
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110000004Q
MA
01
2053802
PK
05
3074461
NH
Enumeration date
05/26/2006
Last updated
07/10/2024
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