MEDICARE: THE STOP & SHOP SUPERMARKET COMPANY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	3350	MA
2	333600000X	Pharmacy	3350	MA
3	3336C0003X	Community/Retail Pharmacy	3350	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2240656	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043242936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE STOP & SHOP SUPERMARKET COMPANY LLC

Provider Business Mailing Address
First Line	:	771 MCGRATH HWY
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02145-2122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	771 MCGRATH HIGHWAY
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02145
Country	:	US
Telephone Number	:	617-666-1404
Fax Number	:	617-666-1344

Authorized Official
Title or Position	:	PRESIDENT OF PHARMACY
Name	:	ROGER WHEELER
Credential	:
Telephone Number	:	207-885-2518

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	05/13/2026

Similar Medicare Providers

1467429274 — DR. W ZOE D STITT MD
Practice Location Address:

349 BROADWAY
SOMERVILLE, MA
02145-2407

Practice Phone: 617-702-8280
Practice Fax: 617-245-6755

1932230976 — LILY S CHEUNG M.D.
Practice Location Address:

5 MIDDLESEX AVE , CHA - OCCUPATIONAL HEALTH
SOMERVILLE, MA
02145-1102

Practice Phone: 617-591-4660
Practice Fax:

1104753318 — ERICA MARGARETA EINHORN
Practice Location Address:

88 PEARL ST UNIT 2
SOMERVILLE, MA
02145-3240

Practice Phone: 973-873-1944
Practice Fax:

1467389924 — TIEN-SHU MIAO
Practice Location Address:

399 REVOLUTION DR STE 950
SOMERVILLE, MA
02145-1579

Practice Phone: 857-304-5930
Practice Fax:

1376541003 — DR. ANTHONY MARK ISHAK PHARM.D.
Practice Location Address:

440 FOLEY ST
SOMERVILLE, MA
02145-1213

Practice Phone: 857-282-0777
Practice Fax:

1558358408 — DR. JULIE LOPES STEPANIAN M.D.
Practice Location Address:

300 BROADWAY , SOMERVILLE PEDIATRICS
SOMERVILLE, MA
02145-2935

Practice Phone: 617-284-7000
Practice Fax: 617-284-7080

Directions to “THE STOP & SHOP SUPERMARKET COMPANY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.