NPIMap

Organization Active NPI

Hannaford Bros Co LLC

Doing business as Hannaford Supermarket & Pharmacy

  • Community/Retail Pharmacy
  • Yarmouth, ME
National Provider Identifier
1659489045
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH50000293 Issued in ME
Legal business name
HANNAFORD BROS CO LLC
Doing business as
Hannaford Supermarket & Pharmacy
Practice address
756 Route 1 Shoppers Village
Yarmouth, ME 04096
Phone
(207) 846-5251
Fax
(207) 846-2233
NPI assigned
Aug 27, 2006
Last updated
May 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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 PH50000293 ME Primary

Addresses

Primary practice location

756 Route 1 Shoppers Village
Yarmouth, ME 04096

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2036334OtherPK
10190729MedicaidME

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
O20100930001517 ME DME Supplier - PharmacyDME Supplier - Grocery Store 1658499157 Practice locations: Yarmouth, 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
Martins Food and Drug 53588 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Locations

756 US Route 1
Yarmouth, ME 04096
Phone (207) 846-5251

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1527724800000",
    "number": "1659489045",
    "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": "756 ROUTE 1 SHOPPERS VILLAGE",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "04096",
            "telephone_number": "207-846-5251",
            "fax_number": "207-846-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANNAFORD BROS CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2018-05-31",
        "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": "PH50000293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2036334",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10190729",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hannaford Supermarket & Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yarmouth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.