Organization
THE STOP & SHOP SUPERMARKET COMPANY LLC
Active
Other names
STOP AND SHOP PHARMACY #679
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER WHEELER (PRESIDENT)
(617) 689-4130
Entity
Organization
Contact information
Practice address
240 CHASE AVE, WATERBURY, CT 06704-2237
(203) 597-1498
(203) 757-7026
Mailing address
240 CHASE AVE, WATERBURY, CT 06704-2237
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1269
CT
333600000X
Pharmacy
1269
CT
3336C0003X
Community/Retail Pharmacy
Primary
1269
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0712059
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
940004065561
—
CT
Enumeration date
07/07/2006
Last updated
09/17/2025
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