NPIMap

Organization Active NPI

The Stop & Shop Supermarket Company LLC

Doing business as Stop & Shop Pharmacy #696

  • Community/Retail Pharmacy
  • West Haven, CT
National Provider Identifier
1720038672
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2048 Issued in CT
Legal business name
THE STOP & SHOP SUPERMARKET COMPANY LLC
Doing business as
Stop & Shop Pharmacy #696
Practice address
460 Elm St
West Haven, CT 06516-4233
Phone
(203) 931-9478
Fax
(203) 937-0855
NPI assigned
May 11, 2006
Last updated
Jan 8, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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

Authorized official

Name
Alison Farrell
Title
Director, Pharmacy Third Party
Phone
(717) 240-1526

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 2048 CT
Community/Retail Pharmacy 3336C0003X 2048 CT Primary

Addresses

Primary practice location

460 Elm St
West Haven, CT 06516-4233

Mailing address

1149 Harrisburg Pike
Carlisle, PA 17013-1607
Phone (717) 240-5520

Other identifiers 2

IdentifierTypeStateIssuer
004260840MedicaidCT
0720501OtherCTNCPDP

Other names 1

  • Stop & Shop Pharmacy #696 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
O20100930033793 CT DME Supplier - PharmacyDME Supplier - Grocery Store 5698841864 Practice locations: West Haven, 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
07D2016834Stop & Shop Pharmacy #696460 Elm St, West Haven, CT 06516Certificate of waiverNov 28, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Stop & Shop Pharmacy #696460 Elm St, West Haven, CT 06516-4233(203) 931-9478 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

Practitioners & affiliated clinicians

Practitioners 2

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": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1720038672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 HARRISBURG PIKE",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170131607",
            "telephone_number": "717-240-5520",
            "fax_number": "717-960-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 ELM ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164233",
            "telephone_number": "203-931-9478",
            "fax_number": "203-937-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE STOP & SHOP SUPERMARKET COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "DIRECTOR, PHARMACY THIRD PARTY",
        "authorized_official_telephone_number": "717-240-1526"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "2048",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "2048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004260840",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0720501",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stop & Shop Pharmacy #696",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.