NPIMap

Organization Active NPI

The Stop & Shop Supermarket Company, LLC

  • Community/Retail Pharmacy
  • East Lyme, CT
National Provider Identifier
1467484337
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1829 Issued in CT
Legal business name
THE STOP & SHOP SUPERMARKET COMPANY, LLC
Practice address
248 Flanders Road
East Lyme, CT 06333
Phone
(860) 739-5957
Fax
(860) 739-9844
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1829 CT
Pharmacy 333600000X 1829 CT
Community/Retail Pharmacy 3336C0003X 1829 CT Primary

Addresses

Primary practice location

248 Flanders Road
East Lyme, CT 06333

Mailing address

248 Flanders Road
East Lyme, CT 06333

Other identifiers 2

IdentifierTypeStateIssuer
004226652MedicaidCT
0719457OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • STOP AND SHOP PHARMACY #665 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CT2 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
O20100930047795 CT DME Supplier - PharmacyDME Supplier - Grocery Store 5698841864 Practice locations: Niantic, CT

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 24

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

View all 24

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": "1730332800000",
    "number": "1467484337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 FLANDERS ROAD",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "06333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 FLANDERS ROAD",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "06333",
            "telephone_number": "860-739-5957",
            "fax_number": "860-739-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE STOP & SHOP SUPERMARKET COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "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": "CT",
            "license": "1829",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CT",
            "license": "1829",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "1829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004226652",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0719457",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP AND SHOP PHARMACY #665",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Lyme, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.