Provider Demographics
NPI:1164584728
Name:HANNAFORD BROS. CO., LLC
Entity Type:Organization
Organization Name:HANNAFORD BROS. CO., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-885-3161
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:MAILSORT 3000
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04104-5005
Mailing Address - Country:US
Mailing Address - Phone:207-885-3161
Mailing Address - Fax:207-885-3121
Practice Address - Street 1:145 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9309
Practice Address - Country:US
Practice Address - Phone:207-885-3161
Practice Address - Fax:207-885-3121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy