Healthcare Provider Details

I. General information

NPI: 1699883074
Provider Name (Legal Business Name): SHOP N SAVE MASS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 FORT EDDY RD
CONCORD NH
03301-7405
US

IV. Provider business mailing address

PO BOX 1000
PORTLAND ME
04104-5005
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-2121
  • Fax: 603-223-9702
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0398P
License Number StateNH

VIII. Authorized Official

Name: MILLARD NANCE
Title or Position: VICE PRESIDENT
Credential:
Phone: 207-885-2348