Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY 5
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
19 HOWLEY ST, PEABODY, MA 01960-5617
(978) 977-3946
(978) 977-5323
Mailing address
19 HOWLEY ST, PEABODY, MA 01960-5617
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
2868
MA
333600000X
Pharmacy
2868
MA
3336C0003X
Community/Retail Pharmacy
Primary
2868
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0447587
—
MA
01
—
2237635
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
10/20/2011
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