NPIMap

Organization Active NPI

Shaws Supermarkets Inc

  • Community/Retail Pharmacy
  • Southbury, CT
National Provider Identifier
1841246865
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PCY0001957 Issued in CT
Legal business name
SHAWS SUPERMARKETS INC
Practice address
775 Main St S
Southbury, CT 06488-2271
Phone
(203) 267-7422
Fax
(203) 267-7454
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PCY0001957 CT Primary

Addresses

Primary practice location

775 Main St S
Southbury, CT 06488-2271

Mailing address

3030 Cullerton St
Franklin Park, IL 60131-2205

Other identifiers 2

IdentifierTypeStateIssuer
0720119OtherNCPDP PROVIDER IDENTIFICATION NUMBER
004248523MedicaidCT

National Provider Directory

National Provider Directory

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": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516665600000",
    "number": "1841246865",
    "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": "775 MAIN ST S",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882271",
            "telephone_number": "203-267-7422",
            "fax_number": "203-267-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWS SUPERMARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "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": "PCY0001957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0720119",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004248523",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, 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.

Verify at the official NPI Registry.