Stop And Shop Pharmacy #648

LBN: Stop And Shop Supermarket Co Llc
Stop And Shop Pharmacy #648 is an health care organization with primary practice located at 112 Amity Rd , New Haven CT 06515-1405. 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) 389-8863, or through Dayton, Brad via phone (617) 770-8782.

Contact Information

Primary practice address
112 Amity Rd New Haven CT 06515-1405
Fax: (203) 387-2232
Website:
Authorized official contact:
Name: Dayton, Brad

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 1470 Connecticut
Suppliers / Pharmacy 333600000X 1470 Connecticut
Suppliers / Community/Retail Pharmacy 3336C0003X 1470 Connecticut

Profile Details

NPI number 1508898479
LBN Legal business name Stop And Shop Supermarket Co Llc
DBA Doing business as Stop And Shop Pharmacy #648
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 1508898479 NPPES
Connecticut MEDICAID 004125721
Connecticut Other 0714712

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