Organization
STOP & SHOP SUPERMARKET COMPANY LLC
Active
Other names
Stop & Shop Pharmacy #2403
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
56 SHANK PAINTER RD, PROVINCETOWN, MA 02657-1342
(508) 487-3738
Mailing address
56 SHANK PAINTER RD, PROVINCETOWN, MA 02657-1342
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
89644
MA
3336C0003X
Community/Retail Pharmacy
Primary
89644
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0423360
—
MA
01
—
2242573
NCPDP
MA
Enumeration date
11/13/2008
Last updated
10/04/2021
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