NPIMap

Organization Active NPI

The Stop & Shop Supermarket Company LLC

Doing business as Stop and Shop Pharmacy #667

  • Community/Retail Pharmacy
  • Waterford, CT
National Provider Identifier
1700818663
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1260 Issued in CT
Legal business name
THE STOP & SHOP SUPERMARKET COMPANY LLC
Doing business as
Stop and Shop Pharmacy #667
Practice address
117 Boston Post Rd
Waterford, CT 06385-2400
Phone
(860) 442-6698
Fax
(860) 443-4807
NPI assigned
Jul 7, 2006
Last updated
Aug 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Authorized official

Name
Roger Wheeler
Title
President
Phone
(207) 885-2911

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1260 CT
Pharmacy 333600000X 1260 CT
Community/Retail Pharmacy 3336C0003X 1260 CT Primary

Addresses

Primary practice location

117 Boston Post Rd
Waterford, CT 06385-2400

Mailing address

117 Boston Post Rd
Waterford, CT 06385-2400

Other identifiers 2

IdentifierTypeStateIssuer
940004064093MedicaidCT
0712011OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • STOP AND SHOP PHARMACY #667 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
O20100930077563 CT DME Supplier - PharmacyDME Supplier - Grocery Store 5698841864 Practice locations: Waterford, 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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2125913Stop & Shop Pharmacy # 667117 Boston Post Rd, Waterford, CT 06385Certificate of waiverFeb 14, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Stop & Shop Pharmacy #667117 Boston Post Rd, Waterford, CT 06385-2400(860) 442-6698 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

Locations

117 Boston Post Rd
Waterford, CT 06385
Phone (860) 442-6698

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1755561600000",
    "number": "1700818663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 BOSTON POST RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 BOSTON POST RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852400",
            "telephone_number": "860-442-6698",
            "fax_number": "860-443-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE STOP & SHOP SUPERMARKET COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-885-2911"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "1260",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CT",
            "license": "1260",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "1260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "940004064093",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0712011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP AND SHOP PHARMACY #667",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.