Organization
SHAWS SUPERMARKETS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMOND HAWKINS (THIRD PARTY MANAGER)
(208) 395-3905
Entity
Organization
Contact information
Practice address
510 ALFRED ST, BIDDEFORD, ME 04005-9432
(207) 286-9315
(207) 284-2135
Mailing address
3030 CULLERTON ST, FRANKLIN PARK, IL 60131-2205
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH50001472
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144820000
—
ME
01
—
2037444
PK
—
Enumeration date
05/26/2006
Last updated
01/23/2018
About Stedi
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