Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY 397
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(671) 770-8782
Entity
Organization
Contact information
Practice address
1 TROWBRIDGE RD, BOURNE, MA 02532-3659
(508) 743-9563
(508) 743-0206
Mailing address
1 TROWBRIDGE RD, BOURNE, MA 02532-3659
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3389
MA
333600000X
Pharmacy
3389
MA
3336C0003X
Community/Retail Pharmacy
Primary
3389
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0407232
—
MA
01
—
2240909
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
10/18/2011
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