NPIMap

Organization Active NPI

Hannaford Bros Co LLC

  • Community/Retail Pharmacy
  • Gray, ME
National Provider Identifier
1710115696
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH50001379 Issued in ME
Legal business name
HANNAFORD BROS CO LLC
Practice address
130 Shaker Rd
Gray, ME 04039-9633
Phone
(207) 657-5832
Fax
(207) 657-5849
NPI assigned
Jun 30, 2009
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Michael Vail
Title
President and Manager
Phone
(207) 885-7454

Practitioners 4

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

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 Supermarket & Pharmacy130 Shaker Rd, Gray, ME 04039-9633(207) 657-5832 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930083043 ME DME Supplier - PharmacyDME Supplier - Grocery Store 1658499157 Practice locations: Gray, 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
Shop N Save Pharmacy88 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

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X PH50001379 ME Primary

Addresses

NPPES NPI Registry

Primary practice location

130 Shaker Rd
Gray, ME 04039-9633

Mailing address

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

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
194860050MedicaidME
2120809OtherPK

Other names 1

NPPES NPI Registry
  • Hannaford Supermarket & Pharmacy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 19, 2025.

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1710115696",
    "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": "130 SHAKER RD",
            "city": "GRAY",
            "state": "ME",
            "postal_code": "040399633",
            "telephone_number": "207-657-5832",
            "fax_number": "207-657-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANNAFORD BROS CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2025-09-19",
        "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": "PH50001379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194860050",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120809",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hannaford Supermarket & Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gray, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.