Stop and Shop Supermarket Co LLC
Organization Active NPI Community/Retail Pharmacy · Stamford, CT
NPI 1033141908 · NPPES record last updated Oct 21, 2011
Key facts
- NPI
- 1033141908
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 01642 (CT)
- Legal business name
- STOP AND SHOP SUPERMARKET CO LLC
- Practice address
- 2200 Bedford St
Stamford, CT 06905-3905 - Phone
- (203) 356-0126
- Fax
- (203) 356-1946
- NPI assigned
- Jul 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Brad Dayton
- Title
- Director
- Phone
- (617) 770-8782
Corporate family (same tax ID) 17
Practitioners 2
-
Sandra Vasthi Narine, DR.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 07D2111008 | Stop & Shop Pharmacy #637 | Certificate of waiver | Mar 28, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Stop and Shop Supermarket Co LLC |
Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Ostomy Supplies|Urological Supplies|Surgical Dressings | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080912000121 | TX | Part B Supplier - Centralized Flu Biller | 5698841864 | This NPI is an additional NPI on the enrollment |
| O20100930002118 | CT | DME Supplier - Pharmacy |
5698841864 | Practice locations: Stamford, CT |
National Provider Directory
- Tax ID family
- Stop Shop Pharmacy 434
Locations
2200 Bedford St
Stamford, CT 06905
Phone (203) 356-0109
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 01642 | CT | |
| Pharmacy | 333600000X | 01642 | CT | |
| Community/Retail Pharmacy | 3336C0003X | 01642 | CT | Yes |
Addresses
Primary practice location
2200 Bedford St
Stamford, CT 06905-3905
Mailing address
2200 Bedford St
Stamford, CT 06905-3905
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 940004177805 | Medicaid | CT | |
| 0717251 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- STOP AND SHOP PHARMACY #637
Other providers in Stamford, CT
- Donald Milton Stokes
- Ben John Stoller
- Ashley Claire Stollman
- Elizabeth S. Stone
- Michael D Stone
- Pamela Lynn Story
- Anna Stransky
- Quinn Strassfield
- Jamie Stratton
- Strawberry Hill Chiropractic PC
All providers in Stamford, CT · Community/Retail Pharmacy in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.