Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY 2605
Organization subpart
No
Provider details
NPI number
Authorized official
ALISON FARRELL (DIRECTOR, THIRD PARTY PHARMACY)
(717) 240-1526
Entity
Organization
Contact information
Practice address
54 HAZARD AVE, ENFIELD, CT 06082-3845
(860) 741-2230
(860) 745-0474
Mailing address
1149 HARRISBURG PIKE, CARLISLE, PA 17013-1607
(717) 240-5520
(717) 960-8371
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1345
CT
333600000X
Pharmacy
1345
CT
3336C0003X
Community/Retail Pharmacy
Primary
1345
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0712833
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
940004087525
—
CT
Enumeration date
07/07/2006
Last updated
01/09/2013
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