# STOP AND SHOP SUPERMARKET CO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** STOP AND SHOP PHARMACY \#705
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376575233
- **Authorized official:** BRAD DAYTON (DIRECTOR)
- **Authorized official phone:** (617) 770-8782

## Contact information

- **Practice address:** 446 PUTNAM PIKE, GREENVILLE, RI 02828-3027
- **Practice address phone:** (401) 949-1848
- **Practice address fax:** (401) 949-1539
- **Mailing address:** 446 PUTNAM PIKE, GREENVILLE, RI 02828-3027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | L239 | RI | — |
| 333600000X | Pharmacy | L239 | RI | — |
| 3336C0003X | Community/Retail Pharmacy | L239 | RI | Yes |

## Other

- **Enumeration date:** 07/07/2006
- **Last updated:** 10/24/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4105020 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | SS10720 | — | RI |