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General NPI Number Information
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NPI Number | 1932128964
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Entity Type | Organization
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Legal Business Name | STOP AND SHOP SUPERMARKET CO LLC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | RT 35S AND TWIN BROOK AVE
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City | MIDDLETOWN
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State | NJ
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Zip | 07748
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Country | US
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Telephone | 732-957-9355
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Fax | 732-957-9192
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Provider Business Mailing Address
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Address Line | RT 35S AND TWIN BROOK AVE
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City | MIDDLETOWN
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State | NJ
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Zip | 07748
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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 | DIR 3RD PARTY MANAGED CARE
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Name | BOB STONE
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Credential |
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Telephone | 781-380-5609
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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 | 6042
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 6042
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License Number State | NJ
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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 | 6042
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License Number State | NJ
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