Organization
THE STOP & SHOP SUPERMARKET COMPANY, LLC
Active
Other names
STOP AND SHOP PHARMACY 817
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON REID (PRESIDENT PHARMACY)
(207) 885-2518
Entity
Organization
Contact information
Practice address
380 W PLEASANTVIEW AVE, HACKENSACK, NJ 07601-8005
(201) 342-0847
(201) 342-5377
Mailing address
1149 HARRISBURG PIKE, CARLISLE, PA 17013-1607
(717) 240-5520
(717) 960-8371
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
6001
NJ
333600000X
Pharmacy
6001
NJ
3336C0003X
Community/Retail Pharmacy
Primary
6001
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3143257
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8706107
—
NJ
Enumeration date
07/07/2006
Last updated
09/16/2024
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