Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY 813
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
160 KINGSLAND RD, CLIFTON, NJ 07014-1915
(973) 779-7831
(973) 779-5245
Mailing address
160 KINGSLAND RD, CLIFTON, NJ 07014-1915
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
005947
NJ
333600000X
Pharmacy
005947
NJ
3336C0003X
Community/Retail Pharmacy
Primary
005947
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3142837
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8450307
—
NJ
Enumeration date
07/07/2006
Last updated
09/23/2011
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