SUPER D DRUGS ACQUISITION CO INC. NPI 1912171208

NPI Information

NPI: 1912171208
Provider Name: SUPER D DRUGS ACQUISITION CO, INC.
Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
2049 E SHILOH RD
CORINTH, MS
ZIP 38834
Phone: (662) 286-6914
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SUPER D DRUGS ACQUISITION CO, INC. is a pharmacy in Corinth, MS. 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 DRUGS ACQUISITION CO, INC. NPI is 1912171208. The provider is registered as an organization entity type.

The provider's business location address is:

2049 E SHILOH RD
CORINTH, MS
ZIP 38834-726
Phone: (662) 286-6914

The provider's authorized official is Kermit R Crawford .
The authorized official title is President and has the following contact phone number (847) 315-3154.

The enumeration date for this NPI number is 4/17/2008 and was last updated on 12/26/2012.

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		01049/01.1	MISSISSIPPI	No
2	3336C0003X	Pharmacy	Community/Retail Pharmacy	01049/01.1	MISSISSIPPI	No
3	333600000X	Pharmacy				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	00045061	OTHER	MISSISSIPPI	DME MEDICAID
2	00093009	OTHER	MISSISSIPPI	MEDICAID PHARMACY
3	0308160001	OTHER	MISSISSIPPI	MEDICARE
4	2508224	OTHER	MISSISSIPPI	NCPDP

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: 5/5/2024

NPI Synchronization or Removal

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