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NPI 1568971216

NPI 1568971216 : SHAWS SUPERMARKETS INC : WOODSVILLE, NH

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General NPI Number Information
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    NPI Number           |    1568971216
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    Entity Type          |    Organization 
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    Legal Business Name  |    SHAWS SUPERMARKETS INC 
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Dates
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    Enumeration Date     |    09/26/2017
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    Last Update Date     |    07/10/2024
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Provider Practice Location Address
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    Address Line         |    15 FOREST ST 
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    City                 |    WOODSVILLE
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    State                |    NH
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    Zip                  |    03785
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    Country              |    US
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    Telephone            |    603-747-5003
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    Fax                  |    603-747-5006
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Provider Business Mailing Address
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    Address Line         |    250 E PARKCENTER BLVD SEC2-B
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83706-3940
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    Country              |    US
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    Telephone            |    208-395-6200
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    Fax                  |    
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Authorized Official
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    Title or Position    |    ENROLLMENT MANAGER
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    Name                 |     KATHY  GIANNAKOPOULOS 
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    Credential           |    
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    Telephone            |    208-395-3932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    333600000X
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    Taxonomy Name        |    Pharmacy
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    04365
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    License Number State |    NH
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