Organization
THE STOP & SHOP SUPERMARKET COMPANY, LLC
Active
Other names
STOP AND SHOP PHARMACY #62
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER WHEELER (PRESIDENT OF PHARMACY)
(207) 885-2518
Entity
Organization
Contact information
Practice address
99 CHARLES ST, MALDEN, MA 02148-6700
(781) 397-0050
(781) 397-7541
Mailing address
99 CHARLES ST, MALDEN, MA 02148-6700
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
2205
MA
333600000X
Pharmacy
2205
MA
3336C0003X
Community/Retail Pharmacy
Primary
2205
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440833
—
MA
01
—
2232697
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
04/09/2025
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