| NPI | 1053343913 |
|---|---|
| Doing Business As | STOP AND SHOP PHARMACY #636 |
| Entity Type | Organization |
| Authorized Contact | BRAD DAYTON Director 617-770-8782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT 1394) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: CT 1394) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 1394) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2011-10-21 |