Organization
THE STOP & SHOP SUPERMARKET COMPANY, LLC
Active
Other names
STOP AND SHOP PHARMACY #638
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
930 N COLONY RD, WALLINGFORD, CT 06492-2471
(203) 265-3942
(203) 269-0131
Mailing address
930 N COLONY RD, WALLINGFORD, CT 06492-2471
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1358
CT
333600000X
Pharmacy
1358
CT
3336C0003X
Community/Retail Pharmacy
Primary
1358
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0713140
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
940004090320
—
CT
Enumeration date
07/19/2006
Last updated
10/31/2024
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