Super Drugs

LBN: Midsouth Medical Specialties Llc
Super Drugs is an health care organization with primary practice located at 1433 Goodman Rd W , Horn Lake MS 38637-1404. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Midsouth Medical Specialties Llc can be contacted via phone (901) 674-3148, or through O'Bannon, Jake via phone (662) 280-7455.

Contact Information

Primary practice address
1433 Goodman Rd W Horn Lake MS 38637-1404
Phone: (901) 674-3148
Fax:
Website:
Map and Directions
Authorized official contact:
Name: O'Bannon, Jake
Phone: (662) 280-7455

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1932864667
LBN Legal business name Midsouth Medical Specialties Llc
DBA Doing business as Super Drugs
Authorized official O'Bannon, Jake
Entity Organization
Organization subpart 1 No
Enumeration date Nov 8th, 2021
Last updated Nov 8th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932864667 NPPES
Mississippi MEDICAID 02434788

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