SUPER D DRUGS ACQUISITION CO. (NPI# 1306929922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306929922 |
| Entity Type | Organization |
| Organization Name | SUPER D DRUGS ACQUISITION CO. |
| Other Organization Name | SUPER D DRUGS #139 |
| Practice Address |
3012 Highway 80 E Pearl MS 39208-3497 |
| Mailing Address |
2100 Brookwood Dr Little Rock AR 72202-1734 |
| Practice Telephone | 6019394813 |
| Practice Fax Number | 6019392749 |
| Mailing Telephone | 5012963337 |
| Mailing Fax Number | 5012963310 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2012-01-26 |
| Authorized Official Name | MR. CHAD COOPER (DIRECTOR OF HME OPERATIONS) |
| Authorized Official Telephone | 5012963337 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 01918012 | MS | Suppliers |
| N | 333600000X | Pharmacy | 01918/01.2 | MS | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2514506 | 01 | |
| MS | 00330375 | 05 | |
| MS | MEDICAID DME | 00440585 | 01 |
| MS | 330375 | 05 | |
| MS | MEDICARE FLU | 870001323 | 01 |
| Other Name | Type Code |
|---|---|
| SUPER D DRUGS #139 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366774374 | Super D Drugs Acquisition Co. | Durable Medical Equipment & Medical Supplies | 513 N Grand Ave, Doniphan, MO 63935-1405 | 2010-02-02 |
| 1780767194 | Super D Drugs Acquisition Co. | Pharmacy | 1028 N Washington Ave, Cookeville, TN 38501-1834 | 2006-10-23 |
| 1821002668 | Super D Drugs Acquisition Co. | Durable Medical Equipment & Medical Supplies | 100 N Grand Ave, Houston, MO 65483-1222 | 2006-07-28 |
| 1609857226 | Super D Drugs Acquisition Co. | Durable Medical Equipment & Medical Supplies | 212 W Main St, Malden, MO 63863-2114 | 2005-11-10 |
| 1679554299 | Super D Drugs Acquisition Co. | Durable Medical Equipment & Medical Supplies | 116 S Walnut St, Bernie, MO 63822-9508 | 2005-11-10 |
| 1568463107 | Super D Drugs Acquisition Co. | Pharmacy | 906 N Douglass St, Malden, MO 63863-1514 | 2005-08-04 |
| 1437288438 | Super D Drugs Acquisition Co. | Durable Medical Equipment & Medical Supplies | 906 N Douglass St, Malden, MO 63863-1514 | 2007-03-05 |
| 1962549709 | Super D Drugs Acquisition Co. | Durable Medical Equipment & Medical Supplies | 1465 N Westwood Blvd, Poplar Bluff, MO 63901-3315 | 2007-01-31 |
| 1700931458 | Super D Drugs Acquisition Co. | Pharmacy | 100 Main St, Gideon, MO 63848 | 2007-01-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | SUPER D DRUGS ACQUISITION CO. | 2100 Brookwood Dr., Little Rock, AR 72202 |
| Street Address |
3012 HIGHWAY 80 E |
| City | PEARL |
| State | MS |
| Zip Code | 39208-3497 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376728683 | James W. Hanson | Pharmacist | 3012 Highway 80 E, Pearl, MS 39208-3497 | 2008-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780299875 | Catherine Leigh Wilson | Nurse Practitioner | 3794 Ms-468, Pearl, MS 39208 | 2020-09-15 |
| 1548896301 | Rochelle Vanity Cork | Nurse Practitioner | 4635 Us-80, Pearl, MS 39208 | 2020-03-12 |
| 1528600343 | Kelsey D Nowell | Physical Therapy Assistant | 3823 Highway 80 East Suite 1100, Pearl, MS 39208 | 2019-10-14 |
| 1740742329 | Jacksonbracey Health Care | Nurse Practitioner | 4490 Us-80, Pearl, MS 39208 | 2019-04-03 |
| 1740637586 | Telehealthone, LLC | Nurse Practitioner | 5760 Hwy 80 East, Pearl, MS 39208 | 2016-05-23 |
| 1003273897 | Xcel Rehab, Inc. | Clinic/Center | 209 Riverwind East, Suite B, Pearl, MS 39208 | 2016-01-25 |
| 1487035044 | Christopher Rogers | Physical Therapy Assistant | 209 B Riverwind East, Pearl, MS 39208 | 2015-06-09 |
| 1417366725 | Pearl River Dental, Pllc | Dentist | 209 Riverwind East Dr, Pearl, MS 39208 | 2014-08-12 |
| 1942614219 | Adams Home Care | Skilled Nursing Facility | 225 Moore St, Pearl, MS 39208 | 2014-06-16 |
| 1437589801 | Leo Easley II | Nurse Practitioner | 3794 Hwy 468, Pearl, MS 39208 | 2013-11-20 |
| Find all providers in zip 39208 | ||||
| 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 |
|---|---|---|---|---|
| 1154459816 | Southeast Foods, Inc. | Pharmacy | 3111 Highway 80 E, Pearl, MS 39208-3503 | 2007-03-02 |
| 1053410365 | Mississippi Cvs Pharmacy, L.L.C. | Pharmacy | 3201 Highway 80 E, Pearl, MS 39208-3502 | 2006-09-22 |
| 1457753428 | New Vision Pharmacy Pearl LLC | Pharmacy | 238 S Pearson Rd, Pearl, MS 39208-5637 | 2014-09-22 |
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|---|---|---|---|---|
| 1164038485 | Quinn's Family Pharmacy of Newton | Pharmacy | 193 Northside Dr, Newton, MS 39345-9523 | 2020-09-22 |
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1649883844 | Natchez Wellness Pharmacy | Pharmacy | 29 Sergeant Prentiss Dr Ste 5, Natchez, MS 39120-4743 | 2020-08-26 |
| 1952910366 | Ct Stamps Inc | Pharmacy | 206 Marion Avenue, Mccomb, MS 39648 | 2020-07-31 |
| 1114566122 | Valley Drugs, Inc. | Pharmacy | 327b S Main St, Water Valley, MS 38965-3318 | 2019-12-23 |
| 1851939318 | Smith Pharmacy, Inc. | Pharmacy | 306 Northside Drive, Newton, MS 39345 | 2019-12-16 |
| 1285270801 | Proxsys Rx - Rush LLC | Pharmacy | 14916 Hwy 16 W, Unit #1, Dekalb, MS 39328 | 2019-11-19 |
| 1518501592 | Southwest Pharmacy Inc | Pharmacy | 3000 Plaza Dr Ste B, Tylertown, MS 39667-9227 | 2019-11-01 |
| 1669015210 | Hometown Family Pharmacy, Inc. | Pharmacy | 930 Hall St Ste H, Wiggins, MS 39577-2113 | 2019-10-25 |
| 1225671001 | A & A Infusion & Specialty, LLC | Pharmacy | 124 E Jackson St, Belzoni, MS 39038-3642 | 2019-10-23 |
| Find all providers with the same taxonomy | ||||
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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.