SUPER ROCKWALL DRUGSTORELP NPI 1467596817

NPI Information

  • NPI: 1467596817
  • Provider Name: SUPER ROCKWALL DRUGSTORE,LP
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: SUPER DRUG
  • Address: 3021 RIDGE RD
    SUITE 103
    ROCKWALL, TX
    ZIP 75032
  • Phone: (972) 772-0500

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NPI Details

SUPER ROCKWALL DRUGSTORE,LP is a community/retail pharmacy pharmacy in Rockwall, TX. 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 ROCKWALL DRUGSTORE,LP NPI is 1467596817. The provider is registered as an organization entity type.
The provider Is Doing Business As Super Drug.

The provider's business location address is:

3021 RIDGE RD
SUITE 103
ROCKWALL, TX
ZIP 75032-806
Phone: (972) 772-0500
Fax: (972) 772-5512

The provider's authorized official is Marites Talavera Serna .
The authorized official title is President and has the following contact phone number (972) 772-0500.

The enumeration date for this NPI number is 2/19/2007 and was last updated on 3/11/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail Pharmacy22390TEXASYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14645790001MEDICARE NSCTEXAS
2145240MEDICAIDTEXAS
3PH0521MEDICARE PIN
422390OTHERTEXASTEXAS PHARMACY LICENSE
5=========MEDICARE UPINTEXAS
6PH0521MEDICARE UPINTEXAS

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: 3/30/2025

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