Organization
STOP AND SHOP SUPERMARKET COMPANY, LLC
Active
Parent organization
AHOLDUSA
Other names
STOP & SHOP PHARMACY 2592
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHOLDUSA
Authorized official
ROGER WHEELER (PRESIDENT OF PHARMACY)
(207) 885-2911
Entity
Organization
Contact information
Practice address
2136 BARTOW AVE, BRONX, NY 10475-4615
(718) 320-2904
(718) 379-9565
Mailing address
1149 HARRISBURG PIKE, ATTN: THIRD PARTY COORDINATOR, CARLISLE, PA 17013-1607
(717) 960-8553
(717) 960-1389
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034064
STATE LICENSE
NY
Enumeration date
10/12/2015
Last updated
05/28/2025
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