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General NPI Number Information
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NPI Number | 1043242902
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Entity Type | Organization
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Legal Business Name | STOP & SHOP SUPERMARKET COMPANY, LLC
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 150 FULTON AVE
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City | HEMPSTEAD
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State | NY
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Zip | 11550-3719
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Country | US
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Telephone | 516-539-2031
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Fax | 516-539-2404
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Provider Business Mailing Address
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Address Line | 150 FULTON AVE
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City | HEMPSTEAD
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State | NY
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Zip | 11550-3719
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | GORDON REID
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Credential |
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Telephone | 301-341-3906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 025128
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 025128
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 025128
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License Number State | NY
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