FREDS OF DONIPHAN INC NPI 1518470970

NPI Information

  • NPI: 1518470970
  • Provider Name: FREDS OF DONIPHAN INC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: SUPER SAVER PHARMACY
  • Address: 100 H&S DRIVE
    DONIPHAN, MO
    ZIP 63935
  • Phone: (573) 996-5220

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NPI Details

FREDS OF DONIPHAN INC is a community/retail pharmacy pharmacy in Doniphan, MO. 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. FREDS OF DONIPHAN INC NPI is 1518470970. The provider is registered as an organization entity type.
The provider Is Doing Business As Super Saver Pharmacy.

The provider's business location address is:

100 H&S DRIVE
DONIPHAN, MO
ZIP 63935
Phone: (573) 996-5220
Fax: (573) 996-3790

The provider's authorized official is Clayton Jamison .
The authorized official title is Owner,ao and has the following contact phone number (573) 996-5220.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home (HCPCS:M0201)
  • Adm sarscov2 100mcg/0.5ml3rd (HCPCS:0013A)
  • Adm sarscv2 30mcg trs-sucr 1 (HCPCS:0051A)

The enumeration date for this NPI number is 11/8/2017 and was last updated on 7/8/2019.

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
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy2018006081MISSOURIYes

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
12173109OTHERPK

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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