Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Parent organization
AHOLDUSA
Other names
STOP & SHOP PHARMACY 2578
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHOLDUSA
Authorized official
RAYMOND MCCALL RPH (SVP HEALTH & HOUSEHOLD)
(717) 960-5666
Entity
Organization
Contact information
Practice address
702 HICKSVILLE RD, MASSAPEQUA, NY 11758-1260
(516) 797-8365
(516) 798-9785
Mailing address
1149 HARRISBURG PIKE, ATTN: THIRD PARTY COORDINATOR, CARLISLE, PA 17013-1607
(717) 960-8553
(717) 960-1389
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034073
STATE LICENSE
NY
Enumeration date
09/30/2015
Last updated
03/07/2023
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