Organization
THE STOP & SHOP SUPERMARKET COMPANY, LLC
Active
Other names
STOP AND SHOP PHARMACY #475
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER WHEELER (PRESIDENT OF PHARMACY)
(207) 885-7454
Entity
Organization
Contact information
Practice address
111 ROUTE 137, HARWICH, MA 02645-2153
(508) 432-5001
(508) 432-5813
Mailing address
PO BOX 1000, PORTLAND, ME 04104-5005
(207) 885-7454
(704) 645-6531
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
2114
MA
333600000X
Pharmacy
2114
MA
3336C0003X
Community/Retail Pharmacy
Primary
2114
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0439673
—
MA
01
—
2231544
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/19/2006
Last updated
04/09/2025
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