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General NPI Number Information
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NPI Number | 1255363123
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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 | 55 LONG POND DR
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City | S YARMOUTH
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State | MA
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Zip | 02664-4161
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Country | US
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Telephone | 508-394-8909
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Fax | 508-394-9035
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Provider Business Mailing Address
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Address Line | 55 LONG POND DR
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City | S YARMOUTH
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State | MA
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Zip | 02664-4161
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2115
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License Number State | MA
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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 | 2115
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License Number State | MA
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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 | 2115
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License Number State | MA
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