Organization
THE STOP & SHOP SUPERMARKET COMPANY LLC
Active
Other names
STOP AND SHOP PHARMACY #429
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER WHEELER (PRESIDENT OF PHARMACY)
(617) 689-4130
Entity
Organization
Contact information
Practice address
1100 MASSACHUSETTS AVE, DORCHESTER, MA 02125-1606
(617) 541-4300
(617) 541-4309
Mailing address
1100 MASSACHUSETTS AVE, DORCHESTER, MA 02125-1606
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
2283
MA
333600000X
Pharmacy
2283
MA
3336C0003X
Community/Retail Pharmacy
Primary
2283
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0409499
—
MA
01
—
2233269
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
05/01/2026
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