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THE STOP AND SHOP SUPERMARKET CO LLC NPI 1972535854


NPI Information

NPI: 1972535854
Provider Name: THE STOP AND SHOP SUPERMARKET CO LLC

Doing Business As: STOP AND SHOP PHARMACY #429

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 22D2187486

Address:
1100 MASSACHUSETTS AVE
DORCHESTER, MA
ZIP 02125
Phone: (617) 541-4300
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THE STOP AND SHOP SUPERMARKET CO LLC is a community/retail pharmacy pharmacy in Dorchester, MA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. THE STOP AND SHOP SUPERMARKET CO LLC NPI is 1972535854. The provider is registered as an organization entity type.
The provider Is Doing Business As Stop And Shop Pharmacy #429.

The provider's business location address is:

1100 MASSACHUSETTS AVE
DORCHESTER, MA
ZIP 02125-606
Phone: (617) 541-4300
Fax: (617) 541-4309

The provider's authorized official is Brad Dayton .
The authorized official title is Director and has the following contact phone number (617) 770-8782.

The CLIA number assigned to this NPI record is 22D2187486 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 8/30/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical Supplies2283MASSACHUSETTSNo
2333600000XPharmacy2283MASSACHUSETTSNo
33336C0003XPharmacyCommunity/Retail Pharmacy2283MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12233269OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
20409499MEDICAIDMASSACHUSETTS
30575340079MEDICARE NSCMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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