Healthcare Provider Details

I. General information

NPI: 1003837055
Provider Name (Legal Business Name): SUPER SAVER PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9089 BELCHER RD N
PINELLAS PARK FL
33782-4423
US

IV. Provider business mailing address

9300 CONROY WINDERMERE RD UNIT 216
WINDERMERE FL
34786-5009
US

V. Phone/Fax

Practice location:
  • Phone: 727-565-2299
  • Fax: 727-499-5418
Mailing address:
  • Phone: 727-565-2299
  • Fax: 727-499-5418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH21573
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AUSTIN SHARP
Title or Position: MANAGER
Credential:
Phone: 727-565-2299