MEDICARE: SUPER D DRUGS ACQUISITION CO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	02075/01.2	MS
2	3336L0003X	Long Term Care Pharmacy
3	332B00000X	Durable Medical Equipment & Medical Supplies	02075012	MS
4	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2511841	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245313659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPER D DRUGS ACQUISITION CO

Provider Business Mailing Address
First Line	:	2100 BROOKWOOD DR
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-1734
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6396 HIGHWAY 51 N
Second Line	:
City	:	HORN LAKE
State	:	MS
Zip	:	38637-2411
Country	:	US
Telephone Number	:	662-342-1550
Fax Number	:	662-342-2094

Authorized Official
Title or Position	:	RETAIL SUPPORT
Name	:	JOYCE STROM
Credential	:
Telephone Number	:	501-296-3312

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	11/16/2007

Similar Medicare Providers

1952399222 — DR. DAVID C. RODRIGUEZ M.D.
Practice Location Address:

101 JOHN ST
LAKE CITY, SC
29560-2411

Practice Phone: 843-394-2031
Practice Fax: 843-394-7411

1134186455 — CAROLINAS MEDICAL ALLIANCE INC
Practice Location Address:

101 JOHN ST
LAKE CITY, SC
29560-2411

Practice Phone: 843-394-2031
Practice Fax:

1437264520 — PERFORMANCE REHAB INSTITUTE & SPORTS MEDICINE, INC.
Practice Location Address:

3450 E LAKE RD , SUITE 101
PALM HARBOR, FL
34685-2411

Practice Phone: 727-781-1223
Practice Fax: 727-772-1161

1174694376 — KARA MEG BACHUS O.D. , F.A.A.O.
Practice Location Address:

4219 W LAKE MARY BLVD
LAKE MARY, FL
32746-2411

Practice Phone: 407-562-4490
Practice Fax:

1386700318 — SHARON RUBICK
Practice Location Address:

2411 LAKE AVE , #21
NORTH MUSKEGON, MI
49445

Practice Phone: 616-813-2679
Practice Fax: 231-719-2809

1497894752 — SHARON RUBICK R.N.
Practice Location Address:

2411 LAKE AVE , #21
NORTH MUSKEGON, MI
49445-3300

Practice Phone: 616-813-2679
Practice Fax: 231-719-2809

Directions to “SUPER D DRUGS ACQUISITION CO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.