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SUPER D DRUGS ACQUISITION CO. NPI 1851474266


NPI Information

NPI: 1851474266
Provider Name: SUPER D DRUGS ACQUISITION, CO.

Doing Business As: IKE'S #2

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
4126 ELVIS PRESLEY BLVD
MEMPHIS, TN
ZIP 38116
Phone: (901) 398-4115
Get Directions

SUPER D DRUGS ACQUISITION, CO. is a community/retail pharmacy pharmacy in Memphis, TN. The provider is 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. SUPER D DRUGS ACQUISITION, CO. NPI is 1851474266. The provider is registered as an organization entity type.
The provider Is Doing Business As Ike's #2.

The provider's business location address is:

4126 ELVIS PRESLEY BLVD
MEMPHIS, TN
ZIP 38116-857
Phone: (901) 398-4115
Fax: (901) 398-4153

The provider's authorized official is Gary M. Boone .
The authorized official title is Director Of Hme Operations and has the following contact phone number (479) 394-6363.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 7/7/2009.


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
1332H00000XEyewear SupplierDPO0000000643TENNESSEENo
2333600000XPharmacy1775TENNESSEENo
3332B00000XDurable Medical Equipment & Medical Supplies1775TENNESSEENo
43336C0003XPharmacyCommunity/Retail PharmacyYes

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
11452336OTHERTENNESSEEMEDICAID DME
2391412OTHERTENNESSEEMEDICARE FLU
34423480OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
49449379MEDICAIDTENNESSEE
51199580042MEDICARE NSCTENNESSEE

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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