Active NPI
Shaws Supermarkets Inc
- Community/Retail Pharmacy
- Johnston, RI
National Provider Identifier
1013963016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHA00354
- Legal business name
- SHAWS SUPERMARKETS INC
- Practice address
- 1485 Hartford Ave
Johnston, RI 02919-3224 - Phone
- (401) 272-2503
- Fax
- (401) 272-6771
- NPI assigned
- May 25, 2006
- Organization subpart
- Yes
- Parent organization
- SUPERVALU INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Lorenzo Torres III
- Title
- New Store Enrollments
- Phone
- (847) 916-4463
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHA00354 | RI | Primary |
Addresses
Primary practice location
1485 Hartford Ave
Johnston, RI 02919-3224
Mailing address
312 Farmington Ave
Farmington, CT 06032-1913
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4105917 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| SS21213 | Medicaid | RI |
Other names 1
- OSCO PHARMACY
National Provider Directory
National Provider Directory- Part of
- Supervalu Inc
Member of 2
Organizations this organization is a member of, according to the National Provider Directory.
Locations
1485 Hartford Ave
Johnston, RI 02919
Phone (401) 272-2503
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1202774400000",
"number": "1013963016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 FARMINGTON AVE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060321913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1485 HARTFORD AVE",
"city": "JOHNSTON",
"state": "RI",
"postal_code": "029193224",
"telephone_number": "401-272-2503",
"fax_number": "401-272-6771"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHAWS SUPERMARKETS INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SUPERVALU INC",
"enumeration_date": "2006-05-25",
"last_updated": "2008-02-12",
"status": "A",
"authorized_official_last_name": "TORRES",
"authorized_official_first_name": "LORENZO",
"authorized_official_title_or_position": "NEW STORE ENROLLMENTS",
"authorized_official_telephone_number": "847-916-4463",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "RI",
"license": "PHA00354",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "4105917",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SS21213",
"state": "RI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "OSCO PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Johnston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.