NPI Database
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Contact Information

STOP AND SHOP SUPERMARKET CO LLC
1135 FARMINGTON AVENUE
BERLIN, CT06037
 Phone: 860-828-0772
 Fax: 860-828-3521
 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 AND SHOP SUPERMARKET CO LLC

NPI Number 1548292410
LBN Legal business name STOP AND SHOP SUPERMARKET CO LLC
Authorized official BRAD DAYTON - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/07/2006
Last updated 10/21/2011 - About 15 years ago
Identifiers
CT License # PCY2004
CT Medicaid 004254413
Other 0720385 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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