Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY #708
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
1360 W MAIN RD, MIDDLETOWN, RI 02842-6301
(401) 849-9640
(401) 849-8048
Mailing address
1360 W MAIN RD, MIDDLETOWN, RI 02842-6301
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
L11
RI
333600000X
Pharmacy
L11
RI
3336C0003X
Community/Retail Pharmacy
Primary
L11
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4104054
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
9010011
—
RI
Enumeration date
07/07/2006
Last updated
10/24/2011
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