Super D Drugs #4
LBN: Super D Drugs Acquisition Co.
Super D Drugs #4 is an health care organization with primary practice located at 1028 N Washington Ave , Cookeville TN 38501-1834. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Super D Drugs Acquisition Co. can be contacted via phone (931) 526-9786, or through Boone, Gary M. via phone (479) 394-6363.
Contact Information
Primary practice address
1028 N Washington Ave
Cookeville TN 38501-1834
Phone: (931) 526-9786
Fax: (931) 520-0936
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 1897 | Tennessee |
| Suppliers / Pharmacy | 333600000X | 1897 | Tennessee |
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1780767194 |
|---|---|
| LBN Legal business name | Super D Drugs Acquisition Co. |
| DBA Doing business as | Super D Drugs #4 |
| Authorized official | Boone, Gary M. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | Nov 18th, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780767194 | NPPES |
| Tennessee | MEDICAID | 9440786 | |
| Tennessee | Other | 1452309 | |
| Tennessee | Other | 3914212 | |
| Tennessee | Other | 4403438 |
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