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Contact Information

STOP & SHOP SUPERMARKET COMPANY LLC
220 RTE 12 GROTON SQ SHOP CENTER
GROTON, CT06340
 Phone: 860-445-8807
 Fax: 860-446-1091
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for STOP & SHOP SUPERMARKET COMPANY LLC

NPI # 1063444925
LBN Legal business name STOP & SHOP SUPERMARKET COMPANY LLC
Authorized official BRAD DAYTON - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/07/2006
Last updated 04/19/2023 - About 3 years ago
Identifiers
CT License # 1297
CT Medicaid 004073839
Other 0712225 OTHER ID NUMBER-COMMERCIAL NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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