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Organization

STOP AND SHOP SUPERMARKET CO LLC

Active
Other names
STOP AND SHOP PHARMACY #600
Organization subpart
No

Provider details

NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization

Contact information

Practice address
2335 DIXWELL AVE, HAMDEN, CT 06514-2100
(203) 248-9631
(203) 407-8406
Mailing address
2335 DIXWELL AVE, HAMDEN, CT 06514-2100

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1565
CT
333600000X
Pharmacy
1565
CT
3336C0003X
Community/Retail Pharmacy
Primary
1565
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0716538
OTHER ID NUMBER-COMMERCIAL NUMBER
05
940004144599
CT
Enumeration date
07/11/2006
Last updated
10/20/2011
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