Stop and Shop Supermarket Co LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

3359 Issued in MA

Legal business name

STOP AND SHOP SUPERMARKET CO LLC

Practice address

341 Plymouth St
Halifax, MA 02338-1340

Phone

(781) 293-5786

Fax

(781) 294-1681

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Brad Dayton

Title

Director

Phone

(671) 770-8782

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• STOP AND SHOP PHARMACY #82 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Lucy Ann Burke, RPH

  • Pharmacy
  • Halifax, MA
  • NPI 1841888625
  NPD (past)
• Peter Roy Krzyzewski, PHARMD

  • Pharmacist
  • Halifax, MA
  • NPI 1932703113
  NPD (past)
• Mary Tavernelli

  • Pharmacist
  • Hyannis, MA
  • NPI 1821763012
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1245262138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 PLYMOUTH ST",
            "city": "HALIFAX",
            "state": "MA",
            "postal_code": "023381340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 PLYMOUTH ST",
            "city": "HALIFAX",
            "state": "MA",
            "postal_code": "023381340",
            "telephone_number": "781-293-5786",
            "fax_number": "781-294-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOP AND SHOP SUPERMARKET CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-10-14",
        "status": "A",
        "authorized_official_last_name": "DAYTON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "671-770-8782"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "3359",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MA",
            "license": "3359",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "3359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2239538",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0406708",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP AND SHOP PHARMACY #82",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shawna Marie Resendes, M.S. CCC-SLP
• Samantha Rice
• Robert Verzone Physical Therapy, LLC
• Teresa Raffaela Smith, PTA
• Maureen Patricia Spencer, RN
• Kim Talbot, PA
• The Anchor Within Counseling & Wellness Center, PLLC
• Town of Halifax
• Town of Halifax
• Robert F Verzone Sr., MPT, PT

• All providers in Halifax, MA
• Community/Retail Pharmacy in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.