Active NPI
Shaws Supermarkets Inc
- Community/Retail Pharmacy
- Boise, ID
National Provider Identifier
1356432231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- SHAWS SUPERMARKETS INC
- Practice address
- 250 E Parkcenter Blvd
Boise, ID 83706-3940 - Phone
- (208) 395-6200
- NPI assigned
- Sep 27, 2006
- Organization subpart
- Yes
- Parent organization
- ALBERTSONS COMPANIES INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kathy Giannakopoulos
- Title
- Enrollments Manager
- Phone
- (208) 395-3954
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
250 E Parkcenter Blvd
Boise, ID 83706-3940
Mailing address
PO Box 742382
Los Angeles, CA 90074-2382
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00447155 | Other | RAILROAD MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051013000589 | TX | Part B Supplier - Centralized Flu Biller | 6305861899 | Practice locations: Boise, ID |
National Provider Directory
National Provider Directory- Tax ID family
- New Albertson'S Inc 7557490
- Part of
- Albertsons Companies Inc
Member of 2
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1587686400000",
"number": "1356432231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 742382",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900742382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 E PARKCENTER BLVD",
"city": "BOISE",
"state": "ID",
"postal_code": "837063940",
"telephone_number": "208-395-6200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHAWS SUPERMARKETS INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ALBERTSONS COMPANIES INC",
"enumeration_date": "2006-09-27",
"last_updated": "2020-04-24",
"certification_date": "2020-04-24",
"status": "A",
"authorized_official_last_name": "GIANNAKOPOULOS",
"authorized_official_first_name": "KATHY",
"authorized_official_title_or_position": "ENROLLMENTS MANAGER",
"authorized_official_telephone_number": "208-395-3954"
},
"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": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "P00447155",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; 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.