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Organization

STOP AND SHOP SUPERMARKET CO LLC

Active
Other names
STOP AND SHOP PHARMACY #564
Organization subpart
No

Provider details

NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization

Contact information

Practice address
575 W MONTAUK HWY, WEST BABYLON, NY 11704-8308
(631) 321-9055
(631) 321-9072
Mailing address
575 W MONTAUK HWY, WEST BABYLON, NY 11704-8308

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
24790
NY
333600000X
Pharmacy
24790
NY
3336C0003X
Community/Retail Pharmacy
Primary
24790
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02079972
NY
01
3315050
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
07/07/2006
Last updated
10/19/2011
About Stedi
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