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Organization

STOP AND SHOP SUPERMARKET CO LLC

Active
Other names
STOP AND SHOP PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
BOB STONE (DIR 3RD PARTY MANAGED CARE)
(617) 770-8732
Entity
Organization

Contact information

Practice address
215 GLASTONBURY BLVD, GLASTONBURY, CT 06033-4408
(860) 659-5844
(860) 657-9710
Mailing address
215 GLASTONBURY BLVD, GLASTONBURY, CT 06033-4408

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1596
CT
333600000X
Pharmacy
1596
CT
3336C0003X
Community/Retail Pharmacy
Primary
1596
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0716855
OTHER ID NUMBER-COMMERCIAL NUMBER
05
940004163060
CT
Enumeration date
07/07/2006
Last updated
06/25/2009
About Stedi
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  • EDI platform