Healthcare Provider Details

I. General information

NPI: 1285680710
Provider Name (Legal Business Name): SHAWS SUPERMARKETS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 12/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 WORCESTER RD
WEBSTER MA
01570-2163
US

IV. Provider business mailing address

3030 CULLERTON ST
FRANKLIN PARK IL
60131-2205
US

V. Phone/Fax

Practice location:
  • Phone: 508-943-8284
  • Fax: 508-943-8928
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2859
License Number StateMA

VIII. Authorized Official

Name: JULIE SCHREINER
Title or Position: MANAGER PLAN IMPLEMENTATION
Credential:
Phone: 847-916-4711