Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY 809
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
940 EASTON AVE, SOMERSET, NJ 08873-1745
(732) 828-0369
(732) 828-0397
Mailing address
940 EASTON AVE, SOMERSET, NJ 08873-1745
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
RS00653900
NJ
333600000X
Pharmacy
RS00653900
NJ
3336C0003X
Community/Retail Pharmacy
Primary
RS00653900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00088161
—
NJ
01
—
3193187
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
09/23/2011
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