Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY #561
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
2650 SUNRISE HWY, EAST ISLIP, NY 11730-1000
(631) 859-5120
(631) 859-5133
Mailing address
2650 SUNRISE HWY, EAST ISLIP, NY 11730-1000
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
24783
NY
333600000X
Pharmacy
24783
NY
3336C0003X
Community/Retail Pharmacy
Primary
24783
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02080082
—
NY
01
—
3316444
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
10/19/2011
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