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General NPI Number Information
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NPI Number | 1285004416
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Entity Type | Organization
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Legal Business Name | STOP AND SHOP SUPERMARKET COMPANY, LLC
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 460 FRANKLIN AVE
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-1226
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Country | US
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Telephone | 516-352-4667
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Fax | 516-358-1947
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Provider Business Mailing Address
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Address Line | 1149 HARRISBURG PIKE ATTN: THIRD PARTY COORDINATOR
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City | CARLISLE
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State | PA
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Zip | 17013-1607
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Country | US
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Telephone | 717-960-8553
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Fax | 717-960-1389
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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 |
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License Number State |
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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 |
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License Number State |
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