NPIMap

Organization Active NPI

The Stop & Shop Supermarket Company, LLC

  • Community/Retail Pharmacy
  • Baldwin Place, NY
National Provider Identifier
1124050083
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
25282 Issued in NY
Legal business name
THE STOP & SHOP SUPERMARKET COMPANY, LLC
Practice address
80 Route 6 Unit 100
Baldwin Place, NY 10505-1028
Phone
(914) 628-8942
Fax
(914) 628-5788
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 25282 NY
Pharmacy 333600000X 25282 NY
Community/Retail Pharmacy 3336C0003X 25282 NY Primary

Addresses

Primary practice location

80 Route 6 Unit 100
Baldwin Place, NY 10505-1028

Mailing address

80 Route 6 Unit 100
Baldwin Place, NY 10505-1028

Other identifiers 3

IdentifierTypeStateIssuer
3324390OtherOTHER ID NUMBER-COMMERCIAL NUMBER
02278393MedicaidNY
354761MedicaidNY

Other names 1

  • STOP AND SHOP PHARMACY 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
O20100930029756 NY DME Supplier - PharmacyDME Supplier - Grocery Store 5698841864 Practice locations: Baldwin Place, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
The Stop & Shop Supermarket Company80 Route 6, Baldwin Place, NY 10505-1026(914) 628-8942 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 assignmentParticipating since Sep 1, 2009

National Provider Directory

National Provider Directory
Tax ID family
Stop Shop Pharmacy 434214 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

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

View all 19

Locations

80 Route 6
Unit 100
Baldwin Place, NY 10505
Phone (914) 628-8942

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1124050083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ROUTE 6 UNIT 100",
            "city": "BALDWIN PLACE",
            "state": "NY",
            "postal_code": "105051028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ROUTE 6 UNIT 100",
            "city": "BALDWIN PLACE",
            "state": "NY",
            "postal_code": "105051028",
            "telephone_number": "914-628-8942",
            "fax_number": "914-628-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE STOP & SHOP SUPERMARKET COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "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"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "25282",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "25282",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "25282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3324390",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02278393",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "354761",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP AND SHOP PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baldwin Place, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.