Healthcare Provider Details

I. General information

NPI: 1316972409
Provider Name (Legal Business Name): THE STOP & SHOP SUPERMARKET COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 PALMER AVE
NEW ROCHELLE NY
10801-4400
US

IV. Provider business mailing address

2425 PALMER AVE
NEW ROCHELLE NY
10801-4400
US

V. Phone/Fax

Practice location:
  • Phone: 914-632-7148
  • Fax: 914-632-7481
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number24359
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number24359
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number24359
License Number StateNY

VIII. Authorized Official

Name: ROGER WHEELER
Title or Position: PRESIDENT
Credential:
Phone: 207-883-2911