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General NPI Number Information
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NPI Number | 1932570363
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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 | 10/12/2015
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | 25 KINNELON RD
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City | KINNELON
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State | NJ
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Zip | 07405-2337
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Country | US
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Telephone | 973-838-6699
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Fax | 973-838-1236
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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 | SVP HEALTH & HOUSEHOLD
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Name | RAYMOND MCCALL
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Credential | RPH
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Telephone | 717-960-5666
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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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