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NPI Code Detail

MEDICARE: HOOK-SUPERX LLC

MEDICARE: HOOK-SUPERX LLC
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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacy60004766AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11507839OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1912000613
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOOK-SUPERX LLC
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line : PO BOX 1075
City : WOONSOCKET
State : RI
Zip : 02895-6146
Country : US
Telephone Number : 401-765-1500
Fax Number :
Provider Business Practice Location Address
First Line : 8970 S MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46217-5031
Country : US
Telephone Number : 317-882-0335
Fax Number :
Authorized Official
Title or Position : DIRECTOR, PAYER RELATIONS
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 09/07/2006
Last Update Date : 02/19/2024

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