| NPI | 1770530222 |
|---|---|
| Doing Business As | SHAWS PHARMACY #1412 |
| Entity Type | Organization |
| Authorized Contact | KATHY GIANNAKOPOULOS Enrollment Manager 208-395-3932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MA DS3262) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2024-07-10 |