NPIMap

Stop and Shop Supermarket Co LLC

Organization Active NPI Community/Retail Pharmacy · Greenville, RI

NPI 1376575233 · NPPES record last updated Oct 24, 2011

Key facts

NPI
1376575233
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
L239 (RI)
Legal business name
STOP AND SHOP SUPERMARKET CO LLC
Practice address
446 Putnam Pike
Greenville, RI 02828-3027
Phone
(401) 949-1848
Fax
(401) 949-1539
NPI assigned
Jul 7, 2006
Organization subpart
No

Authorized official

Name
Brad Dayton
Title
Director
Phone
(617) 770-8782

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 3

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

Laboratory certificates & supplier records

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Stop and Shop Supermarket Co LLC
446 Putnam Pike, Greenville, RI 02828-3027 · (401) 949-1848		 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
Participating since Sep 1, 2009

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TX, RI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080912000121 TX Part B Supplier - Centralized Flu Biller 5698841864 This NPI is an additional NPI on the enrollment
O20100930068789 RI DME Supplier - Pharmacy
DME Supplier - Grocery Store		 5698841864 Practice locations: Greenville, RI

National Provider Directory

Tax ID family
Stop Shop Pharmacy 434 (214 organizations share this tax ID)

Locations

446 Putnam Pike
Greenville, RI 02828
Phone (401) 556-6621

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X L239 RI
Pharmacy 333600000X L239 RI
Community/Retail Pharmacy 3336C0003X L239 RI Yes

Addresses

Primary practice location

446 Putnam Pike
Greenville, RI 02828-3027

Mailing address

446 Putnam Pike
Greenville, RI 02828-3027

Other identifiers

IdentifierTypeStateIssuer
4105020OtherOTHER ID NUMBER-COMMERCIAL NUMBER
SS10720MedicaidRI

Other names

  • STOP AND SHOP PHARMACY #705 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 24, 2011.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319414400000",
    "number": "1376575233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 PUTNAM PIKE",
            "city": "GREENVILLE",
            "state": "RI",
            "postal_code": "028283027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 PUTNAM PIKE",
            "city": "GREENVILLE",
            "state": "RI",
            "postal_code": "028283027",
            "telephone_number": "401-949-1848",
            "fax_number": "401-949-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOP AND SHOP SUPERMARKET CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-10-24",
        "status": "A",
        "authorized_official_last_name": "DAYTON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-770-8782"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "RI",
            "license": "L239",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "RI",
            "license": "L239",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "RI",
            "license": "L239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4105020",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SS10720",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP AND SHOP PHARMACY #705",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, RI

All providers in Greenville, RI · Community/Retail Pharmacy in Rhode Island

Sources for this page

Verify at the official NPI Registry.