NPIMap

Organization Active NPI

The Stop & Shop Supermarket Company, LLC

Doing business as Stop and Shop Pharmacy #604

  • Community/Retail Pharmacy
  • Naugatuck, CT
National Provider Identifier
1508898461
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1348 Issued in CT
Legal business name
THE STOP & SHOP SUPERMARKET COMPANY, LLC
Doing business as
Stop and Shop Pharmacy #604
Practice address
727 Rubber Av Mt View Plaza
Naugatuck, CT 06770
Phone
(203) 723-6939
Fax
(203) 729-3898
NPI assigned
Jul 7, 2006
Last updated
Sep 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1348 CT
Pharmacy 333600000X 1348 CT
Community/Retail Pharmacy 3336C0003X 1348 CT Primary

Addresses

Primary practice location

727 Rubber Av Mt View Plaza
Naugatuck, CT 06770

Mailing address

727 Rubber Av Mt View Plaza
Naugatuck, CT 06770

Other identifiers 2

IdentifierTypeStateIssuer
940004087070MedicaidCT
0712958OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • STOP AND SHOP PHARMACY #604 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
O20100930066847 CT DME Supplier - PharmacyDME Supplier - Grocery Store 5698841864 Practice locations: Naugatuck, CT

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
Stop & Shop Pharmacy #604727 Rubber Ave, Naugatuck, CT 06770-3642(203) 723-6939 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 022214 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": "1727049600000",
    "number": "1508898461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 RUBBER AV MT VIEW PLAZA",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "06770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 RUBBER AV MT VIEW PLAZA",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "06770",
            "telephone_number": "203-723-6939",
            "fax_number": "203-729-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE STOP & SHOP SUPERMARKET COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "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": "CT",
            "license": "1348",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CT",
            "license": "1348",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "1348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "940004087070",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0712958",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP AND SHOP PHARMACY #604",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naugatuck, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.