Super D Express Rx #8407

LBN: Super D Drugs Acquisition Co.
Super D Express Rx #8407 is an health care organization with primary practice located at 1465 N Westwood Blvd , Poplar Bluff MO 63901-3315. The organization recently has only one registered license in Suppliers / Durable Medical Equipment & Medical Supplies, which is considered as the primary health care specialty. Super D Drugs Acquisition Co. can be contacted via phone (573) 686-1461, or through Boone, Gary via phone (479) 394-6363.

Contact Information

Primary practice address
1465 N Westwood Blvd Poplar Bluff MO 63901-3315
Phone: (573) 686-1461
Fax: (573) 785-0831
Website:
Map and Directions
Authorized official contact:
Name: Boone, Gary
Phone: (479) 394-6363

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1962549709
LBN Legal business name Super D Drugs Acquisition Co.
DBA Doing business as Super D Express Rx #8407
Authorized official Boone, Gary
Entity Organization
Organization subpart 1 No
Enumeration date Jan 31st, 2007
Last updated Jan 9th, 2010 - about 14 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 1962549709 NPPES
Missouri MEDICAID 620200402

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