NPIMap

Organization Active NPI

Hannaford Bros Co LLC

  • Community/Retail Pharmacy
  • North Conway, NH
National Provider Identifier
1689756181
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0362 Issued in NH
Legal business name
HANNAFORD BROS CO LLC
Practice address
32 Mountain Valley Blvd.
North Conway, NH 03860
Phone
(603) 356-6361
Fax
(603) 356-8370
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 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 0362 NH Primary

Addresses

Primary practice location

32 Mountain Valley Blvd.
North Conway, NH 03860

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
2053043OtherPK
30004883MedicaidNH
3080721MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930089525 NH DME Supplier - PharmacyDME Supplier - Grocery Store 1658499157 Practice locations: No Conway, NH
O20110128000952 NH Part B Supplier - Mass Immunization (Roster Biller Only) 1658499157 21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Lebanon, NH; Meredith, NH; North Conway, NH; Northwood, NH; Ossipee, NH; Plymouth, NH; Raymond, NH; Rindge, NH…

Other NPIs on the same Medicare enrollment 21

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 21

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hannaford Bros Co LLC32 Mountain Valley Blvd., No Conway, NH 03860-3058(603) 356-6361 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Ostomy Supplies|Urological Supplies|Surgical Dressings Accepts assignmentParticipating since Jan 1, 2001

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 16

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

View all 16

Locations

32 Mountain Valley Mall Blvd
North Conway, NH 03860
Phone (603) 356-6361

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524182400000",
    "number": "1689756181",
    "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": "32 MOUNTAIN VALLEY BLVD.",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "03860",
            "telephone_number": "603-356-6361",
            "fax_number": "603-356-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANNAFORD BROS CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2018-04-20",
        "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": "NH",
            "license": "0362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2053043",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004883",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3080721",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Conway, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.