Organization Active NPI

Hannaford Bros Co LLC

  • Community/Retail Pharmacy
  • Portland, ME
National Provider Identifier
1013025402
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH50000076 Issued in ME
Legal business name
HANNAFORD BROS CO LLC
Practice address
295 Forest Ave
Portland, ME 04101-2018
Phone
(207) 761-5967
Fax
(207) 879-4010
NPI assigned
Aug 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Vail
Title
President and Manager
Phone
(207) 885-7454

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X PH50000076 ME Primary

Addresses

Primary practice location

295 Forest Ave
Portland, ME 04101-2018

Mailing address

PO Box 1000
Ms 3000
Portland, ME 04104-5005
Phone (207) 885-7454

Other identifiers 2

IdentifierTypeStateIssuer
2036218OtherPK
999101379MedicaidME

Other names 1

  • Hannaford Supermarket & Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930026504 ME DME Supplier - PharmacyDME Supplier - Grocery Store 1658499157 Practice locations: Portland, ME
O20101110001111 ME Part B Supplier - Mass Immunization (Roster Biller Only) 1658499157 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Shop N Save Pharmacy88 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

295 Forest Ave
Portland, ME 04101
Phone (207) 761-5967

295 Forest Ave
Ste 7
Portland, ME 04101

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1013025402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "address_2": "MS 3000",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045005",
            "telephone_number": "207-885-7454",
            "fax_number": "704-645-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 FOREST AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012018",
            "telephone_number": "207-761-5967",
            "fax_number": "207-879-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANNAFORD BROS CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "VAIL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT AND MANAGER",
        "authorized_official_telephone_number": "207-885-7454"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ME",
            "license": "PH50000076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2036218",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "999101379",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hannaford Supermarket & Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.