Organization
STOP & SHOP SUPERMARKET COMPANY, LLC
Active
Parent organization
AHOLDUSA
Other names
STOP & SHOP PHARMACY 2584
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHOLDUSA
Authorized official
MR. RAYMOND MCCALL RPH (THIRD PARTY COORDINATOR)
(717) 960-5666
Entity
Organization
Contact information
Practice address
130 WHEATLEY PLZ, GREENVALE, NY 11548-1344
(516) 484-1414
(516) 484-1371
Mailing address
1149 HARRISBURG PIKE, ATTN: APRIL HOOVER, CARLISLE, PA 17013-1607
(717) 960-8553
(717) 960-1389
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NY
3336C0003X
Community/Retail Pharmacy
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034059
STATE LICENSE
NY
Enumeration date
09/11/2015
Last updated
03/07/2023
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