Super Drug Mart

LBN: Super Drug Mart, Inc.
Super Drug Mart is an health care organization with primary practice located at 5555 Fredericksburg Rd Suite 105, San Antonio TX 78229-3500. The organization recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as the primary health care specialty. Super Drug Mart, Inc. can be contacted via phone (210) 495-7516, or through Ibanez, Raymond D via phone (830) 709-0360.

Contact Information

Primary practice address
5555 Fredericksburg Rd Suite 105 San Antonio TX 78229-3500
Phone: (210) 495-7516
Fax: (210) 340-6998
Website:
Map and Directions
Authorized official contact:
Name: Ibanez, Raymond D PHARM.D.
Phone: (830) 709-0360

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 20307 Texas

Profile Details

NPI number 1447631734
LBN Legal business name Super Drug Mart, Inc.
DBA Doing business as Super Drug Mart
Authorized official Ibanez, Raymond D PHARM.D.
Entity Organization
Organization subpart 1 No
Enumeration date Jun 12th, 2015
Last updated Jun 12th, 2015 - about 10 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 1447631734 NPPES
Texas MEDICAID 144974
Texas Other 20307

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