Healthcare Provider Details

I. General information

NPI: 1811084023
Provider Name (Legal Business Name): SUPERIOR PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2006
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 N CENTRAL AVE
SUPERIOR NE
68978-1715
US

IV. Provider business mailing address

PO BOX 308
SUPERIOR NE
68978-0308
US

V. Phone/Fax

Practice location:
  • Phone: 402-879-4234
  • Fax: 402-879-3131
Mailing address:
  • Phone: 402-879-4234
  • Fax: 402-879-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANDREW CARTER
Title or Position: PRESIDENT
Credential:
Phone: 402-879-4234