Active NPI
Shaws Supermarkets Inc
- Community/Retail Pharmacy
- Clinton, CT
National Provider Identifier
1376599761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 1608
- Legal business name
- SHAWS SUPERMARKETS INC
- Practice address
- 266 E Main St
Clinton, CT 06413-2254 - Phone
- (860) 669-6619
- Fax
- (860) 669-1368
- NPI assigned
- May 26, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Demond Hawkins
- Title
- Third Party Manager
- Phone
- (208) 395-3905
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 1608 | CT | Primary |
Addresses
Primary practice location
266 E Main St
Clinton, CT 06413-2254
Mailing address
3030 Cullerton St
Franklin Park, IL 60131-2205
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004162088 | Medicaid | CT | |
| 0716956 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
National Provider Directory
National Provider Directory- Tax ID family
- New Albertson's Inc 7557490
Organizations with this tax ID in the same state 5
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Community/Retail Pharmacy
- Newington, CT
- NPI 1730135120
-
dba Shaws Osco Pharmacy
- Community/Retail Pharmacy
- New Britain, CT
- NPI 1821044215
Locations
266 E Main St
Clinton, CT 06413
Phone (860) 669-6619
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1516665600000",
"number": "1376599761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 CULLERTON ST",
"city": "FRANKLIN PARK",
"state": "IL",
"postal_code": "601312205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "266 E MAIN ST",
"city": "CLINTON",
"state": "CT",
"postal_code": "064132254",
"telephone_number": "860-669-6619",
"fax_number": "860-669-1368"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHAWS SUPERMARKETS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-26",
"last_updated": "2018-01-23",
"status": "A",
"authorized_official_last_name": "HAWKINS",
"authorized_official_first_name": "DEMOND",
"authorized_official_title_or_position": "THIRD PARTY MANAGER",
"authorized_official_telephone_number": "208-395-3905"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CT",
"license": "1608",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004162088",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "0716956",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.