| Organization Name: | THE STOP & SHOP SUPERMARKET CO LLC |
| NPI Number: | 1063881803 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAYMOND MCCALL (THIRD PARTY COORDINATOR) |
| Mailing Address: | 15601 Crossbay Blvd Howard Beach |
| State: | NY US |
| Postal Code: | 114142746 |
| Phone Number: | 7186419853 |
| Fax Number: | 7187386884 |
| NPI Enumeration Date: | 09/23/2015 |
| NPI Last Update Date: | 04/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |