Organization
STOP & SHOP SUPERMARKET COMPANY LLC
Active
Other names
STOP AND SHOP PHARMACY #689
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
286 BROAD ST, MANCHESTER, CT 06040-4034
(860) 647-0325
(860) 533-7185
Mailing address
286 BROAD ST, MANCHESTER, CT 06040-4034
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1452
CT
333600000X
Pharmacy
1452
CT
3336C0003X
Community/Retail Pharmacy
Primary
1452
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0714522
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
940004122438
—
CT
Enumeration date
07/07/2006
Last updated
05/05/2023
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