SUPER D DRUGS ACQUISTION CO. NPI 1770582009

NPI Information

NPI: 1770582009
Provider Name: SUPER D DRUGS ACQUISTION CO.
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Doing Business As: JIM BAIN'S PHARMACY
Address: 367 N GLOSTER ST
TUPELO, MS
ZIP 38804
Phone: (662) 844-4530

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NPI Details

SUPER D DRUGS ACQUISTION CO. is a durable medical equipment medical supplies in Tupelo, MS. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. SUPER D DRUGS ACQUISTION CO. NPI is 1770582009. The provider is registered as an organization entity type.
The provider Is Doing Business As Jim Bain's Pharmacy.

The provider's business location address is:

367 N GLOSTER ST
TUPELO, MS
ZIP 38804-633
Phone: (662) 844-4530
Fax: (662) 844-9927

The provider's authorized official is David Stroud .
The authorized official title is Vp Pharmacy Services and has the following contact phone number (501) 296-3311.

The enumeration date for this NPI number is 7/19/2005 and was last updated on 7/16/2008.

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
1	332B00000X	Durable Medical Equipment & Medical Supplies		04930/11.1	MISSISSIPPI	Yes

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
1	1199580114	MEDICARE NSC	MISSISSIPPI
2	00440682	OTHER	MISSISSIPPI	MEDICAID DME
3	00M4996	OTHER	MISSISSIPPI	EDI DME

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: 11/21/2025

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