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NPI 1063444941

NPI 1063444941 : THE STOP & SHOP SUPERMARKET COMPANY, LLC : KINGSTON, MA

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General NPI Number Information
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    NPI Number           |    1063444941
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    Entity Type          |    Organization 
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    Legal Business Name  |    THE 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     |    04/09/2025
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Provider Practice Location Address
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    Address Line         |    160 SUMMER ST 
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    City                 |    KINGSTON
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    State                |    MA
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    Zip                  |    02364-1226
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    Country              |    US
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    Telephone            |    781-582-3703
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    Fax                  |    781-582-3717
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Provider Business Mailing Address
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    Address Line         |    160 SUMMER ST 
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    City                 |    KINGSTON
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    State                |    MA
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    Zip                  |    02364-1226
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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    |    PRESIDENT OF PHARMACY
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    Name                 |     ROGER  WHEELER 
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    Credential           |    
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    Telephone            |    207-885-2518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    333600000X
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    Taxonomy Name        |    Pharmacy
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    License Number       |    2260
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    License Number State |    MA
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Taxonomy #2
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    2260
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    License Number State |    MA
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