| Name: | Suburban Pharmacy, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 19 Jun 1930 (95 years ago) |
| Identification Number: | 000044618 |
| ZIP code: | 02888 |
| County: | Kent County |
| Principal Address: | 242 PAWTUXET AVE, WARWICK, RI, 02888, USA |
| Purpose: | PHARMACY AND OTC, HBA, CONVENIENCE ITEMS |
NAICS
446110 Pharmacies and Drug StoresThis industry comprises establishments known as pharmacies and drug stores engaged in retailing prescription or nonprescription drugs and medicines. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245373307 | 2007-02-15 | 2013-12-03 | 242 PAWTUXET AVE, WARWICK, RI, 028881933, US | 242 PAWTUXET AVE, WARWICK, RI, 028881933, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 401-781-2110 |
| Fax | 4017812640 |
Authorized person
| Name | NICHOLAS SHANOS |
| Role | OWNER AND PRESIDENT |
| Phone | 4017812110 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PHA00136 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2088084 |
| Issuer | MEDICAID |
| Number | SP00071 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| NICHOLAS SHANOS | Agent | 242 PAWTUXET AVENUE, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| NICHOLAS SHANOS | TREASURER | 242 PAWTUXET AVENUE WARWICK, RI 02888 USA |
| Name | Role | Address |
|---|---|---|
| NICHOLAS SHANOS | SECRETARY | 242 PAWTUXET AVENUE WARWICK, RI 02888 USA |
| Name | Role | Address |
|---|---|---|
| NICHOLAS SHANOS | PRESIDENT | 242 PAWTUXET AVENUE WARWICK, RI 02888- USA |
| Name | Role | Address |
|---|---|---|
| NICHOLAS SHANOS | VICE PRESIDENT | 242 PAWTUXET AVENUE WARWICK, RI 02888 USA |
| Number | Name | File Date |
|---|---|---|
| 202448742120 | Annual Report | 2024-03-16 |
| 202329362720 | Annual Report | 2023-02-26 |
| 202212993060 | Annual Report | 2022-03-16 |
| 202187579430 | Annual Report | 2021-01-22 |
| 202037003120 | Annual Report | 2020-03-31 |
| 201988007540 | Annual Report | 2019-03-01 |
| 201861859260 | Annual Report | 2018-04-10 |
| 201739481300 | Annual Report | 2017-04-03 |
| 201692735430 | Annual Report | 2016-02-20 |
| 201553671820 | Annual Report | 2015-01-13 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8897287008 | 2020-04-09 | 0165 | PPP | 242 PAWTUXET AVE, WARWICK, RI, 02888-1933 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 07 Apr 2025
Sources: Rhode Island Department of State
