Organization Name: | SUPER D DRUG ACQUISITION CO., INC. |
NPI Number: | 1881629780 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY BOONE (PRESIDENT) |
Mailing Address: | 1201 Office Park Dr Suite 2 Oxford |
State: | MS US |
Postal Code: | 386553598 |
Phone Number: | 6622347666 |
Fax Number: | 6622361211 |
NPI Enumeration Date: | 07/11/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 04340/02.1 |
Healthcare Provider Taxonomy: (Secondary) | X |
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 |