Organization
THE STOP & SHOP SUPERMARKET COMPANY, LLC
Active
Other names
STOP AND SHOP PHARMACY #675
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON REID (DIRECTOR)
(207) 885-2518
Entity
Organization
Contact information
Practice address
920 WOLCOTT ST, WATERBURY, CT 06705-1300
(203) 755-9538
(203) 755-9908
Mailing address
920 WOLCOTT ST, WATERBURY, CT 06705-1300
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1781
CT
333600000X
Pharmacy
1781
CT
3336C0003X
Community/Retail Pharmacy
Primary
1781
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0718998
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
940004215233
—
CT
Enumeration date
07/11/2006
Last updated
10/30/2024
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