Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY #579
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
294 MIDDLE COUNTRY RD, CORAM, NY 11727-4428
(631) 736-5168
(631) 736-5733
Mailing address
294 MIDDLE COUNTRY RD, CORAM, NY 11727-4428
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
026960
NY
333600000X
Pharmacy
026960
NY
3336C0003X
Community/Retail Pharmacy
Primary
026960
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02598790
—
NY
01
—
3339707
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
10/19/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us