Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY #615
Organization subpart
No
Provider details
NPI number
Authorized official
BOB STONE (DIR 3RD PARTY MANAGED CARE)
(617) 770-6257
Entity
Organization
Contact information
Practice address
42 TOWN ST, NORWICH, CT 06360-2316
(860) 887-1615
(860) 886-6207
Mailing address
42 TOWN ST, NORWICH, CT 06360-2316
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
00937
CT
333600000X
Pharmacy
00937
CT
3336C0003X
Community/Retail Pharmacy
Primary
00937
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0714774
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
940004126109
—
CT
Enumeration date
07/07/2006
Last updated
06/25/2009
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