Stop And Shop Pharmacy #629

LBN: Stop And Shop Supermarket Co Llc
Stop And Shop Pharmacy #629 is an health care organization with primary practice located at 898 Bridgeport Ave , Shelton CT 06484-4625. 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) 929-3887, or through Dayton, Brad via phone (617) 770-8732.

Contact Information

Primary practice address
898 Bridgeport Ave Shelton CT 06484-4625
Fax: (203) 929-3999
Website:
Authorized official contact:
Name: Dayton, Brad

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 1187 Connecticut
Suppliers / Pharmacy 333600000X 1187 Connecticut
Suppliers / Community/Retail Pharmacy 3336C0003X 1187 Connecticut

Profile Details

NPI number 1174555031
LBN Legal business name Stop And Shop Supermarket Co Llc
DBA Doing business as Stop And Shop Pharmacy #629
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174555031 NPPES
Other 0711982 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID 940004049854 OTHER ID NUMBER-COMMERCIAL NUMBER

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