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Organization

STOP & SHOP SUPERMARKET COMPANY, LLC

Active
Parent organization
AHOLDUSA
Other names
STOP & SHOP PHARMACY 2588
Organization subpart
Yes

Provider details

NPI number
Legal business name
AHOLDUSA
Authorized official
ROGER WHEELER (PRESIDENT OF PHARMACY)
(207) 885-2518
Entity
Organization

Contact information

Practice address
4055 MERRICK RD, SEAFORD, NY 11783-2830
(516) 826-6767
(516) 826-4477
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
034055
STATE LICENSE
NY
Enumeration date
09/30/2015
Last updated
05/27/2025
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