SUPER D DRUGS ACQUISITION, CO. (NPI# 1225111636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225111636 |
| Entity Type | Organization |
| Organization Name | SUPER D DRUGS ACQUISITION, CO. |
| Other Organization Name | IKE'S #3 |
| Practice Address |
2145 Union Ave Memphis TN 38104-4206 |
| Mailing Address |
803 Highway 71 N Mena AR 71953-4367 |
| Practice Telephone | 9012743107 |
| Practice Fax Number | 9012744012 |
| Mailing Telephone | 4793946363 |
| Mailing Fax Number | 4793941046 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2009-07-07 |
| Authorized Official Name | MR. GARY M. BOONE (DIRECTOR OF HME OPERATIONS) |
| Authorized Official Telephone | 4793946363 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | DPO0000000590 | TN | Suppliers |
| N | 333600000X | Pharmacy | 1899 | TN | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 1899 | TN | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4412588 | 01 | |
| TN | 9448252 | 05 | |
| TN | MEDICAID DME | 1453337 | 01 |
| TN | MEDICARE FLU | 3914212 | 01 |
| Other Name | Type Code |
|---|---|
| IKE'S #3 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679656086 | Super D Drugs Acquisition, Co. | Eyewear Supplier (Equipment, not the service) | 5040 Park Ave, Memphis, TN 38117-5709 | 2006-10-23 |
| 1851474266 | Super D Drugs Acquisition, Co. | Eyewear Supplier (Equipment, not the service) | 4126 Elvis Presley Blvd, Memphis, TN 38116-5857 | 2006-10-23 |
| Street Address |
2145 UNION AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-4206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699058909 | Ron L Williams | Pharmacist | 2145 Union Ave, Memphis, TN 38104-4206 | 2011-09-22 |
| 1396027488 | Dawn Renee Wilburn-goo | Pharmacist | 2145 Union Ave, Memphis, TN 38104-4206 | 2011-09-14 |
| 1316261001 | Yolanda Tyson | Pharmacist | 2145 Union Ave, Memphis, TN 38104-4206 | 2010-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069965 | Plaza Pharmacy LLC | Pharmacy | 3024 Covington Pike Ste 5, Memphis, TN 38128-5043 | 2020-06-30 |
| 1699398602 | Walgreen Co | Pharmacy | 262 Danny Thomas Pl Ste 100rx, Memphis, TN 38105-3678 | 2020-05-26 |
| 1740831072 | Avita Drugs Tennessee, LLC | Pharmacy | 806 S Cooper St Ste A, Memphis, TN 38104-5406 | 2019-09-27 |
| 1619536570 | A Transition To Independence | Pharmacy | 2778 Treasure Island Dr E, Memphis, TN 38115-1707 | 2019-06-13 |
| 1992248702 | Anovorx Group LLC | Pharmacy | 1710 Shelby Oaks Dr N Ste 5, Memphis, TN 38134-7403 | 2016-11-28 |
| 1104207166 | Good Shepherd Medication Management | Pharmacy | 6052 Hickory Ridge Mall Ste 148, Memphis, TN 38115 | 2015-06-16 |
| 1710372214 | Getwell Pharmacy LLC | Pharmacy | 3960 Knight Arnold Rd Ste 112, Memphis, TN 38118-3001 | 2015-04-01 |
| 1518397199 | Freds Stores of Tennessee Inc | Pharmacy | 1290 Lamar Ave, Memphis, TN 38104 | 2013-11-19 |
| 1073946091 | Quality Rx Compounding LLC | Pharmacy | 920 Estate Dr Ste 8, Memphis, TN 38119-3608 | 2013-08-13 |
| 1417209016 | Freds Stores of Tennessee Inc | Pharmacy | 7965 E Shelby Dr, Memphis, TN 38125-3755 | 2012-10-05 |
| Find all providers in MEMPHIS | ||||
Please comment or provide details below to improve the information on SUPER D DRUGS ACQUISITION, CO..
| 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.