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SUPER D DRUG ACQUISITION CO. NPI 1528064367


NPI Information

NPI: 1528064367
Provider Name: SUPER D DRUG ACQUISITION CO.

Doing Business As: HOLLY'S HEALTH MART #23

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
1430 W 1ST ST N
PRESCOTT, AR
ZIP 71857
Phone: (870) 887-2717
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SUPER D DRUG ACQUISITION CO. is a pharmacy in Prescott, AR. The provider is 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. SUPER D DRUG ACQUISITION CO. NPI is 1528064367. The provider is registered as an organization entity type.
The provider Is Doing Business As Holly's Health Mart #23.

The provider's business location address is:

1430 W 1ST ST N
PRESCOTT, AR
ZIP 71857-339
Phone: (870) 887-2717
Fax: (870) 887-2113

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 6/27/2005 and was last updated on 11/12/2009.


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
1333600000XPharmacy65694ARKANSASYes

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
10417926OTHERARKANSASPHARMACY
2165425407MEDICAIDARKANSAS

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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