Stop And Shop Pharmacy #624
LBN: Stop And Shop Supermarket Co Llc
Stop And Shop Pharmacy #624 is an health care organization with primary practice located at 136 Samson Rock Dr , Madison CT 06443-3018. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Stop And Shop Supermarket Co Llc can be contacted via phone (203) 245-7467, or through Dayton, Brad via phone (617) 770-8782.
Contact Information
Primary practice address
136 Samson Rock Dr
Madison CT 06443-3018
Phone: (203) 245-7467
Fax: (203) 245-7014
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 1748 | Connecticut |
| Suppliers / Pharmacy | 333600000X | 1748 | Connecticut |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 1748 | Connecticut |
Profile Details
| NPI number | 1104858075 |
|---|---|
| LBN Legal business name | Stop And Shop Supermarket Co Llc |
| DBA Doing business as | Stop And Shop Pharmacy #624 |
| Authorized official | Dayton, Brad |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 7th, 2006 |
| Last updated | Oct 21st, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104858075 | NPPES |
| Connecticut | MEDICAID | 940004203387 | |
| Connecticut | MEDICAID | 004203387 | |
| Connecticut | Other | 0718544 |
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