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Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY #544
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
425 PORTION RD, LAKE RONKONKOMA, NY 11779-4579
(631) 737-1736
(631) 737-2879
Mailing address
425 PORTION RD, LAKE RONKONKOMA, NY 11779-4579
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
026854
NY
333600000X
Pharmacy
026854
NY
3336C0003X
Community/Retail Pharmacy
Primary
026854
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02586478
—
NY
01
—
3339618
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
10/19/2011
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