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SUPER DRUG MART INC. NPI 1447631734


NPI Information

NPI: 1447631734
Provider Name: SUPER DRUG MART, INC.

Doing Business As: SUPER DRUG MART

Classification: Pharmacist - 183500000X
Entity Type: Organization
Address:
5555 FREDERICKSBURG RD
SUITE 105
SAN ANTONIO, TX
ZIP 78229
Phone: (210) 495-7516
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SUPER DRUG MART, INC. is a pharmacist in San Antonio, TX. The provider is an individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. SUPER DRUG MART, INC. NPI is 1447631734. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Super Drug Mart.

The provider's business location address is:

5555 FREDERICKSBURG RD
SUITE 105
SAN ANTONIO, TX
ZIP 78229-500
Phone: (210) 495-7516
Fax: (210) 340-6998

The provider's authorized official is Raymond D Ibanez .
The authorized official title is Owner/pharmacist and has the following contact phone number (830) 709-0360.

The enumeration date for this NPI number is 6/12/2015 and was last updated on 6/12/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1183500000XPharmacist20307TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1144974MEDICAIDTEXAS
21208570001MEDICARE NSCTEXAS
320307OTHERTEXASSTATE BOARD OF PHARMACY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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