Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY 807
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
1129 STATE ROUTE 34, MATAWAN, NJ 07747-2166
(732) 583-9500
(732) 290-1365
Mailing address
1129 STATE ROUTE 34, MATAWAN, NJ 07747-2166
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
6043
NJ
333600000X
Pharmacy
6043
NJ
3336C0003X
Community/Retail Pharmacy
Primary
6043
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08713600
—
NJ
01
—
3143396
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
09/23/2011
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