SUPER D DRUGS ACQUISITION CO, INC. (NPI# 1912171208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912171208 |
| Entity Type | Organization |
| Organization Name | SUPER D DRUGS ACQUISITION CO, INC. |
| Practice Address |
2049 E Shiloh Rd Corinth MS 38834-3726 |
| Mailing Address |
2100 Brookwood Dr Little Rock AR 72202-1734 |
| Practice Telephone | 6622866914 |
| Mailing Telephone | 2177092386 |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2012-12-26 |
| Authorized Official Name | KERMIT R CRAWFORD (PRESIDENT) |
| Authorized Official Telephone | 8473153154 |
| Is Organization Subpart | Y |
| Parent Organization Name | WALGREEN CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 01049/01.1 | MS | Suppliers |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
01049/01.1 | MS | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | DME MEDICAID | 00045061 | 01 |
| MS | MEDICAID PHARMACY | 00093009 | 01 |
| MS | NCPDP | 2508224 | 01 |
| MS | MEDICARE | 0308160001 | 01 |
| Street Address |
2049 E SHILOH RD |
| City | CORINTH |
| State | MS |
| Zip Code | 38834-3726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306923271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2049 E Shiloh Rd, Corinth, MS 38834-3726 | 2006-10-31 |
| 1932750049 | Brieanna Holmes | Pharmacist | 2049 E Shiloh Rd, Corinth, MS 38834-3726 | 2019-09-20 |
| 1487207270 | Dylan Rider | Pharmacist | 2049 E Shiloh Rd, Corinth, MS 38834-3726 | 2019-07-20 |
| 1396259966 | Shiloh Apothecary | Pharmacy | 2049 E Shiloh Rd, Corinth, MS 38834-3726 | 2017-11-19 |
| 1043454069 | Amanda J. Wilburn | Pharmacist | 2049 E Shiloh Rd, Corinth, MS 38834-3726 | 2009-04-21 |
| 1164643425 | Tedric Hight | Pharmacist | 2049 E Shiloh Rd, Corinth, MS 38834-3726 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176824 | Crystalcare | Clinic/Center | 3124 N Shiloh Road, Corinth, MS 38834 | 2020-05-20 |
| 1962046680 | Wanda Lee Kilpatrick | Technician | 1206 Breckenridge St., Corinth, MS 38834 | 2019-11-06 |
| 1215595756 | Alanna Nunez Heflin | Dentist | 3127 E Shiloh Rd, Corinth, MS 38834 | 2019-05-30 |
| 1629530795 | A Port In The Storm (apits) | Clinic/Center | 102 N. Cass Street, Suite B, Corinth, MS 38834 | 2019-04-05 |
| 1538654199 | Jerry Wayne Latch | Durable Medical Equipment & Medical Supplies | 206 N Fillmore St, Corinth, MS 38834 | 2018-06-26 |
| 1194215681 | Brooks Medical Clinic | Clinic/Center | 2113 South Tate Street, Corinth, MS 38834 | 2018-05-10 |
| 1164938650 | Pediatric Dentistry of Corinth | Dentist | 1500 N Harper Rd #5, Pediatric Dentistry of Corinth, Corinth, MS 38834 | 2017-12-19 |
| 1467964536 | King Speech-language Therapy, LLC | Speech-Language Pathologist | 2203 Hwy 72 East, Corinth, MS 38834 | 2017-10-30 |
| 1841669728 | Glenda Gatlin | Social Worker | 14 Cr 305, Corinth, MS 38834 | 2015-09-21 |
| 1649646555 | Amanda Word | Social Worker | 303 North Madison Street, Corinth, MS 38834 | 2015-08-14 |
| Find all providers in zip 38834 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750315537 | Kroger Limited Partnership I | Pharmacy | 104 Highway 72 W, Corinth, MS 38834-5511 | 2006-07-10 |
| 1609808641 | Freds Stores of Tennessee Inc | Pharmacy | 2040 E Shiloh Rd, Corinth, MS 38834-3727 | 2006-07-07 |
| 1073544193 | K Mart Corp | Pharmacy | 118 Highway 72 W, Corinth, MS 38834-5511 | 2006-07-06 |
| 1215378922 | Copharma Inc | Pharmacy | 127 Pratt Dr, Corinth, MS 38834-6026 | 2013-07-10 |
| 1437481645 | Borroums Rexall Drug Store Inc | Pharmacy | 604 E Waldron St, Corinth, MS 38834-4863 | 2010-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457973067 | Thomas Street Compounding Pharmacy | Pharmacy | 115 N Thomas St Ste G, Tupelo, MS 38801-3082 | 2020-05-18 |
| 1013558824 | Downhome Pharmacy, Inc. | Pharmacy | 606 W. Broad St, Monticello, MS 39654 | 2019-10-02 |
| 1356997985 | Sonshine Pharmacy, LLC | Pharmacy | 2745 Highway 371 N, Mantachie, MS 38855 | 2019-08-09 |
| 1699331868 | Fulton Specialty Pharmacy, LLC | Pharmacy | 1509 S Adams St Ste D, Fulton, MS 38843-6621 | 2019-05-14 |
| 1063971539 | National Pharmacy of Mississippi, LLC | Pharmacy | 371b Highland Colony Pkwy, Ridgeland, MS 39157-6035 | 2019-03-14 |
| 1811468952 | Davidson Pharmacy, LLC | Pharmacy | 203a N 2nd St, Booneville, MS 38829-2701 | 2018-12-16 |
| 1346710720 | Tupelo Specialty Pharmacy, LLC | Pharmacy | 1056 Cliff Gookin Blvd Ste C, Tupelo, MS 38801-6458 | 2018-11-28 |
| 1205302254 | A & A Infusion & Specialty, LLC | Pharmacy | 423 Mcallister St, Greenville, MS 38701-4704 | 2018-10-17 |
| 1306325402 | Family Drug Mart of Poplarville,llc | Pharmacy | 100 Highway 11 N, Poplarville, MS 39470-2217 | 2018-08-09 |
| 1851883789 | Amory Discount Pharmacy, LLC | Pharmacy | 60379 Cotton Gin Port Rd Ste B, Amory, MS 38821-7204 | 2018-06-06 |
| 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.