Organization Name: | SUPER D DRUGS ACQUISITION CO. |
NPI Number: | 1306929922 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHAD COOPER (DIRECTOR OF HME OPERATIONS) |
Mailing Address: | 3012 Highway 80 E Pearl |
State: | MS US |
Postal Code: | 392083497 |
Phone Number: | 6019394813 |
Fax Number: | 6019392749 |
NPI Enumeration Date: | 10/24/2006 |
NPI Last Update Date: | 01/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 01918012 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MS |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |