Stop & Shop Supermarket Company, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

3290 Issued in MA

Legal business name

STOP & SHOP SUPERMARKET COMPANY, LLC

Doing business as

Stop and Shop Pharmacy #55

Practice address

932 N Montello St
Brockton, MA 02301-1671

Phone

(508) 427-6582

Fax

(508) 427-6977

NPI assigned

Jul 11, 2006

Last updated

Jul 29, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gordon Reid

Title

President

Phone

(301) 341-3906

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• STOP AND SHOP PHARMACY #55 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1154356186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 N MONTELLO ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 N MONTELLO ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011671",
            "telephone_number": "508-427-6582",
            "fax_number": "508-427-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOP & SHOP SUPERMARKET COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "GORDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-341-3906"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "3290",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MA",
            "license": "3290",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "3290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2240327",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0405922",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP AND SHOP PHARMACY #55",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Diane Stewmon, FNP-BC
• Charis Lynn Stone-Racer, MSW
• Andrew Douglas Stone, M.D.
• Julie M. Stone, M.D.
• Lauren E Stone, RD,LDN
• Caroline Storey, LADC; CADC
• Samantha Ann Strachoff, LICSW
• Eileen Stran-Joy
• Susan M Stratoti, SLP
• Sarah Strauch, DS

• Community/Retail Pharmacy in Brockton, MA
• Providers in Brockton, MA by specialty
• Community/Retail Pharmacy in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.