Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY #593
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
670 N BROADWAY, N WHITE PLAINS, NY 10603-2409
(914) 682-0743
(914) 682-3341
Mailing address
670 N BROADWAY, N WHITE PLAINS, NY 10603-2409
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
024602
NY
333600000X
Pharmacy
024602
NY
3336C0003X
Community/Retail Pharmacy
Primary
024602
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02116030
—
NY
01
—
3319248
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
10/20/2011
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