NPIMap

Organization Active NPI

The Stop & Shop Supermarket Company LLC

Doing business as Stop and Shop Pharmacy #605

  • Community/Retail Pharmacy
  • Glastonbury, CT
National Provider Identifier
1912932013
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PCY1821 Issued in CT
Legal business name
THE STOP & SHOP SUPERMARKET COMPANY LLC
Doing business as
Stop and Shop Pharmacy #605
Practice address
55 Oak St
Glastonbury, CT 06033-2315
Phone
(860) 652-9208
Fax
(860) 652-9298
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Authorized official

Name
Roger Wheeler
Title
President
Phone
(617) 689-4130

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PCY1821 CT
Pharmacy 333600000X PCY1821 CT
Community/Retail Pharmacy 3336C0003X PCY1821 CT Primary

Addresses

Primary practice location

55 Oak St
Glastonbury, CT 06033-2315

Mailing address

55 Oak St
Glastonbury, CT 06033-2315

Other identifiers 2

IdentifierTypeStateIssuer
0719344OtherOTHER ID NUMBER-COMMERCIAL NUMBER
940004225927MedicaidCT

Other names 1

  • STOP AND SHOP PHARMACY #605 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
O20100930045667 CT DME Supplier - PharmacyDME Supplier - Grocery Store 5698841864 Practice locations: Glastonbury, 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
07D2016831Stop & Shop Pharmacy #60555 Oak St, Glastonbury, CT 06033Certificate of waiverNov 28, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
The Stop & Shop Supermarket Company55 Oak St, Glastonbury, CT 06033-2315(860) 652-9208 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 and Shop Pharmacy214 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Locations

55 Oak St
Glastonbury, CT 06033
Phone (860) 652-9208

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1912932013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 OAK ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 OAK ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332315",
            "telephone_number": "860-652-9208",
            "fax_number": "860-652-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE STOP & SHOP SUPERMARKET COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-689-4130"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "PCY1821",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CT",
            "license": "PCY1821",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY1821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0719344",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "940004225927",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP AND SHOP PHARMACY #605",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.