SUPER D DRUGS ACQUISITION CO (NPI# 1154404564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154404564 |
| Entity Type | Organization |
| Organization Name | SUPER D DRUGS ACQUISITION CO |
| Other Organization Name | SUPER D DRUGS |
| Practice Address |
2055 Raymond Rd Jackson MS 39204-4131 |
| Mailing Address |
2100 Brookwood Dr Little Rock AR 72202-1734 |
| Practice Telephone | 6013720662 |
| Practice Fax Number | 6013720667 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2007-11-19 |
| Authorized Official Name | JOYCE STROM (RETAIL SUPPORT) |
| Authorized Official Telephone | 5012963312 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | 01012/01.2 | MS | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 01012012 | MS | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2514114 | 01 | |
| MS | MEDICAID DME | 00440775 | 01 |
| MS | 330373 | 05 | |
| MS | 00330373 | 05 |
| Other Name | Type Code |
|---|---|
| SUPER D DRUGS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992042964 | Super D Drugs Acquisition Co | Pharmacy | 3022 N Midland Dr, Pine Bluff, AR 71603-4829 | 2013-01-11 |
| 1508197047 | Super D Drugs Acquisition Co | Durable Medical Equipment & Medical Supplies | 907 West Business Hwy. 60, Dexter, MO 63841 | 2010-01-22 |
| 1558440891 | Super D Drugs Acquisition Co | Pharmacy | 300 East 8th Street, Danville, AR 72833 | 2006-11-06 |
| 1417030032 | Super D Drugs Acquisition Co | Pharmacy | 516 Nakoma Dr, Jackson, MS 39206-3332 | 2006-10-24 |
| 1104909738 | Super D Drugs Acquisition Co | Pharmacy | 527 W Kearney St, Springfield, MO 65803-2523 | 2006-10-24 |
| 1295818821 | Super D Drugs Acquisition Co | Durable Medical Equipment & Medical Supplies | 201 S 28th Avenue, Hattiesburg, MS 39401 | 2006-10-24 |
| 1013090646 | Super D Drugs Acquisition Co | Pharmacy | 2565 E Sunshine St, Springfield, MO 65804-1824 | 2006-10-24 |
| 1417030826 | Super D Drugs Acquisition Co | Pharmacy | 225 E Pacific St, Springfield, MO 65803-2832 | 2006-10-23 |
| 1245313659 | Super D Drugs Acquisition Co | Pharmacy | 6396 Highway 51 N, Horn Lake, MS 38637-2411 | 2006-10-23 |
| 1235212648 | Super D Drugs Acquisition Co | Pharmacy | 3050 S National Ave Ste 109, Springfield, MO 65804-4242 | 2006-10-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | SUPER D DRUGS ACQUISITION CO. | 2100 Brookwood Dr., Little Rock, AR 72202 |
| Street Address |
2055 RAYMOND RD |
| City | JACKSON |
| State | MS |
| Zip Code | 39204-4131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639797442 | Walk By Faith Not By Sight Homecare | Student in an Organized Health Care Education/Training Program | 2310 Us-80 West, Suite F 1154, Jackson, MS 39204 | 2020-07-08 |
| 1427593888 | Care First Home Care Agency, Inc | In Home Supportive Care | 931 Hwy 80 Suite 2 B-9, Jackson, MS 39204 | 2016-12-21 |
| 1134678808 | Yolonda Kinzie | Registered Nurse | 1134 Winter St., Jackson, MS 39204 | 2016-09-23 |
| 1578983938 | Seaneather Arline Mcgill | Nurse's Aide | 2024 Shady Lane Dr, Jackson, MS 39204 | 2014-04-23 |
| 1942591128 | Real Solutilons, LLC | Exclusive Provider Organization | 831 Hwy 80 W., Jackson, MS 39204 | 2011-04-22 |
| 1548405236 | Visions Physical Therapy | Specialist/Technologist | 4700 Robinson Rd, Jackson, MS 39204 | 2008-12-09 |
| 1588759393 | Donald H Butts | Specialist | 1920 Chadwick Drive, Suite 109, Jackson, MS 39204 | 2006-10-04 |
| 1003907460 | Patrick E Weldon | Psychiatry & Neurology | 1860 Chadwick Drive, Suite 258, Jackson, MS 39204 | 2006-09-28 |
| 1922117662 | Elgin Kenneth Walley | Dentist | 2174 Henry Hill Drive, Jackson, MS 39204 | 2006-08-29 |
| 1376555045 | Linda Nell Hunter | Nurse Practitioner | 1860 Chadwick Dr Ste 150a, Jackson, MS 39204 | 2006-08-12 |
| Find all providers in zip 39204 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| 1952823783 | Teton County Hospital District | Pharmacy | 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 | 2017-07-13 |
| 1477955037 | Jackson Village Pharmacy LLC | Pharmacy | 27 South Cooks Bridge Rd, Suite M1, Jackson, NJ 08527 | 2014-09-25 |
| 1215341623 | Rite Aid | Pharmacy | 702 Bennett Mills Road, Jackson, NJ 08527 | 2014-06-13 |
| 1134251812 | Main Midtown Inc | Pharmacy | 346 E Fortification St, Jackson, MS 39202-2325 | 2007-03-09 |
| 1003943176 | Ljc,inc Dba Stone Drug | Pharmacy | 830 West Broadway, Box 9000, Jackson, WY 83001 | 2007-02-27 |
| 1003968322 | Carel Pharmacy | Pharmacy | 2010 W County Line Rd, Jackson, NJ 08527-2001 | 2007-01-17 |
| 1316095573 | Gold Kimball International, Inc. | Pharmacy | 2080 W County Line Rd, Jackson, NJ 08527-2015 | 2007-01-06 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.