Organization
STOP & SHOP SUPERMARKET COMPANY LLC
Active
Other names
STOP AND SHOP PHARMACY #682
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
220 RTE 12 GROTON SQ SHOP CENTER, GROTON, CT 06340
(860) 445-8807
(860) 446-1091
Mailing address
220 RTE 12 GROTON SQ SHOP CENTER, GROTON, CT 06340
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1297
CT
333600000X
Pharmacy
1297
CT
3336C0003X
Community/Retail Pharmacy
Primary
1297
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004073839
—
CT
01
—
0712225
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
04/19/2023
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