NPIMap

Organization Active NPI

The Stop & Shop Supermarket Company LLC

Doing business as Stop and Shop Pharmacy #429

  • Community/Retail Pharmacy
  • Dorchester, MA
National Provider Identifier
1972535854
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2283 Issued in MA
Legal business name
THE STOP & SHOP SUPERMARKET COMPANY LLC
Doing business as
Stop and Shop Pharmacy #429
Practice address
1100 Massachusetts Ave
Dorchester, MA 02125-1606
Phone
(617) 541-4300
Fax
(617) 541-4309
NPI assigned
Jul 7, 2006
Last updated
May 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 2283 MA
Pharmacy 333600000X 2283 MA
Community/Retail Pharmacy 3336C0003X 2283 MA Primary

Addresses

Primary practice location

1100 Massachusetts Ave
Dorchester, MA 02125-1606

Mailing address

1100 Massachusetts Ave
Dorchester, MA 02125-1606

Other identifiers 2

IdentifierTypeStateIssuer
0409499MedicaidMA
2233269OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • STOP AND SHOP PHARMACY #429 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MA2 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
O20100930077566 MA DME Supplier - Pharmacy 5698841864 Practice locations: Dorchester, MA

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
22D2187486Stop and Shop Pharmacy #4291100 Massachusetts Avenue, Dorchester, MA 02125Certificate of waiverJul 1, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
The Stop & Shop Supermarket Company1100 Massachusetts Ave, Dorchester, MA 02125-1606(617) 541-4300 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 13

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

View all 13

Locations

1100 Massachusetts Ave
Dorchester, MA 02125
Phone (617) 541-4300

Practitioners & affiliated clinicians

Practitioners 3

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": "1777593600000",
    "number": "1972535854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MASSACHUSETTS AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021251606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MASSACHUSETTS AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021251606",
            "telephone_number": "617-541-4300",
            "fax_number": "617-541-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE STOP & SHOP SUPERMARKET COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT OF PHARMACY",
        "authorized_official_telephone_number": "617-689-4130"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "2283",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MA",
            "license": "2283",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "2283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0409499",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2233269",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STOP AND SHOP PHARMACY #429",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.