Organization
THE STOP & SHOP SUPERMARKET COMPANY, LLC
Active
Other names
STOP AND SHOP PHARMACY #618
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
410 REIDVILLE DR, WATERBURY, CT 06705-2633
(203) 755-5814
(203) 574-2675
Mailing address
410 REIDVILLE DR, WATERBURY, CT 06705-2633
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
01439
CT
333600000X
Pharmacy
01439
CT
3336C0003X
Community/Retail Pharmacy
Primary
01439
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0714560
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
940004123163
—
CT
Enumeration date
07/07/2006
Last updated
10/31/2024
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