Stop and Shop Supermarket Co LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

6007 Issued in NJ

Legal business name

STOP AND SHOP SUPERMARKET CO LLC

Doing business as

Stop and Shop Pharmacy 831

Practice address

675 Paterson Ave
Carlstadt, NJ 07072-1601

Phone

(201) 842-9985

Fax

(201) 842-9987

NPI assigned

Jul 7, 2006

Last updated

Feb 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alison Farrell

Title

Director, Third Party

Phone

(717) 240-1526

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• STOP AND SHOP PHARMACY 831 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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.

• Kerolos Samy, RPH

  • Pharmacist
  • Carlstadt, NJ
  • NPI 1467224337
  NPD (past)
• Erin Young

  • Pharmacist
  • Carlstadt, NJ
  • NPI 1790359669
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1821020777",
    "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": "675 PATERSON AVE",
            "city": "CARLSTADT",
            "state": "NJ",
            "postal_code": "070721601",
            "telephone_number": "201-842-9985",
            "fax_number": "201-842-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOP AND SHOP SUPERMARKET CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "DIRECTOR, THIRD PARTY",
        "authorized_official_telephone_number": "717-240-1526"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": "6007",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "6007",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "6007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3143269",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8637202",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP AND SHOP PHARMACY 831",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Carlstadt, NJ
• Providers in Carlstadt, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.