Stop & Shop Supermarket Company, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

STOP & SHOP SUPERMARKET COMPANY, LLC

Doing business as

Stop & Shop Pharmacy 2584

Practice address

130 Wheatley PLZ
Greenvale, NY 11548-1344

Phone

(516) 484-1414

Fax

(516) 484-1371

NPI assigned

Sep 11, 2015

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

AHOLDUSAAs reported in NPPES

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

Authorized official

Name

Mr. Raymond McCall, RPH

Title

Third Party Coordinator

Phone

(717) 960-5666

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• STOP & SHOP PHARMACY 2584 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1881062511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 HARRISBURG PIKE",
            "address_2": "ATTN: APRIL HOOVER",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170131607",
            "telephone_number": "717-960-8553",
            "fax_number": "717-960-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 WHEATLEY PLZ",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "115481344",
            "telephone_number": "516-484-1414",
            "fax_number": "516-484-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOP & SHOP SUPERMARKET COMPANY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AHOLDUSA",
        "enumeration_date": "2015-09-11",
        "last_updated": "2023-03-07",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "MCCALL",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "THIRD PARTY COORDINATOR",
        "authorized_official_telephone_number": "717-960-5666",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "034059",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP & SHOP PHARMACY 2584",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "STOP & SHOP PHARMACY 2584",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jill Sonnenklar, PHD
• St. Francis Cardiac Prevention, P.C.
• St. Francis Diagnostic
• St. Francis Hospital
• Stacey F Brisman MD PC (Walk- In Dermatology)
• Geraldine Anne Sweikata, NP-C
• Avni Thakore, M.D.
• Ali Yahya Tug, MD
• Dawn Marie Tumulty, PSY.D.
• Ebubekir Ucar

• Community/Retail Pharmacy in Greenvale, NY
• Providers in Greenvale, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.