NPIMap

Organization Active NPI

New Albertson's Inc #7557/490

Doing business as Shaws Osco Pharmacy

  • Community/Retail Pharmacy
  • Ellsworth, ME
National Provider Identifier
1881961589
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PR4615 Issued in ME
Legal business name
NEW ALBERTSON'S INC #7557/490
Doing business as
Shaws Osco Pharmacy
Practice address
175 High St
Ellsworth, ME 04605-1730
Phone
(207) 669-3005
Fax
(207) 669-3013
NPI assigned
Nov 23, 2011
Organization subpart
Yes
Parent organization
NEW ALBERTSON'S INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Ivan Boudreau, RPHNPI 1518244649
Title
Staff Pharmacist
Phone
(207) 669-3005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PR4615 ME Primary

Addresses

Primary practice location

175 High St
Ellsworth, ME 04605-1730

Mailing address

175 High St
Ellsworth, ME 04605-1730
Phone (207) 669-3005

Other names 1

  • Shaws Osco Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shaws Supermarkets Inc66 organizations share this tax ID, including this one
Part of
Shaws Supermarkets Inc

Organizations with this tax ID in the same state 12

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1322006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1881961589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 HIGH ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051730",
            "telephone_number": "207-669-3005",
            "fax_number": "207-669-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 HIGH ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051730",
            "telephone_number": "207-669-3005",
            "fax_number": "207-669-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ALBERTSON'S INC #7557/490",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW ALBERTSON'S INC",
        "enumeration_date": "2011-11-23",
        "last_updated": "2011-11-23",
        "status": "A",
        "authorized_official_last_name": "BOUDREAU",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "IVAN",
        "authorized_official_title_or_position": "STAFF PHARMACIST",
        "authorized_official_telephone_number": "207-669-3005",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ME",
            "license": "PR4615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shaws Osco Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellsworth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.