=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790717684
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE STOP & SHOP SUPERMARKET COMPANY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/07/2006
-----------------------------------------------------
Last Update Date | 10/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 FAUNCE CORNER RD
-----------------------------------------------------
City | DARTMOUTH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02747-4202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-999-7300
-----------------------------------------------------
Fax | 508-999-3137
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 FAUNCE CORNER RD
-----------------------------------------------------
City | DARTMOUTH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02747-4202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT OF PHARMACY
-----------------------------------------------------
Name | ROGER WHEELER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 207-885-2518
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 2987
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 2987
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 2987
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------