NPIMap

Organization Active NPI

The Stop & Shop Supermarket Company, LLC

Doing business as Stop & Shop Pharmacy 2589

  • Community/Retail Pharmacy
  • Ozone Park, NY
National Provider Identifier
1073982815
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
THE STOP & SHOP SUPERMARKET COMPANY, LLC
Doing business as
Stop & Shop Pharmacy 2589
Practice address
92-10 Atlantic Ave
Ozone Park, NY 11417
Phone
(718) 835-7903
Fax
(718) 641-3530
NPI assigned
Sep 23, 2015
Last updated
Apr 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
AHOLDUSAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Roger Wheeler
Title
President of Pharmacy
Phone
(207) 885-2518

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NY
Community/Retail Pharmacy 3336C0003X NY Primary

Addresses

Primary practice location

92-10 Atlantic Ave
Ozone Park, NY 11417

Mailing address

1149 Harrisburg Pike
Attn: April Hoover
Carlisle, PA 17013-1607
Phone (717) 960-8553

Other identifiers 1

IdentifierTypeStateIssuer
034056OtherNYSTATE LICENSE

Other names 1

  • STOP & SHOP PHARMACY 2589 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080912000121 TX Part B Supplier - Centralized Flu Biller 5698841864 This NPI is an additional NPI on the enrollment
O20160413002308 NY DME Supplier - Pharmacy 5698841864 Practice locations: Ozone Park, NY

National Provider Directory

National Provider Directory
Tax ID family
Stop Shop Pharmacy 022214 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Locations

9210 Atlantic Ave
Ozone Park, NY 11416
Phone (718) 835-7903

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1073982815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 HARRISBURG PIKE",
            "address_2": "ATTN: APRIL HOOVER",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170131607",
            "telephone_number": "717-960-8553",
            "fax_number": "717-960-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92-10 ATLANTIC AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "11417",
            "telephone_number": "718-835-7903",
            "fax_number": "718-641-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE STOP & SHOP SUPERMARKET COMPANY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AHOLDUSA",
        "enumeration_date": "2015-09-23",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT OF PHARMACY",
        "authorized_official_telephone_number": "207-885-2518",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "034056",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP & SHOP PHARMACY 2589",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.