Active NPI
Hook-Superx LLC
Doing business as CVS Pharmacy# 10190
- Pharmacy
- Fort Wayne, IN
National Provider Identifier
1104257146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- HOOK-SUPERX LLC
- Doing business as
- CVS Pharmacy# 10190
- Practice address
- 770 E Dupont Rd
Fort Wayne, IN 46825-2056 - Phone
- (260) 451-8242
- NPI assigned
- Dec 2, 2013
- Last updated
- Apr 22, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Colbert
- Title
- Director
- Phone
- (401) 765-1500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | NU | Primary | |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
770 E Dupont Rd
Fort Wayne, IN 46825-2056
Mailing address
1 CVS Dr
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201213420A | Medicaid | IN | |
| 1564966 | Other | NCPDP |
Other names 1
- CVS Pharmacy# 10190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101018000112 | IN | Part B Supplier - Mass Immunization (Roster Biller Only) | 1658310602 |
This NPI is an additional NPI on the enrollment Practice locations: Indianapolis, IN |
| O20140312001063 | IN | DME Supplier - Pharmacy | 1658310602 | Practice locations: Ft Wayne, IN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #10190 | Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Hook Superx LLC
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385942400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1398124800000",
"number": "1104257146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146",
"telephone_number": "401-765-1500",
"fax_number": "401-770-7108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 E DUPONT RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468252056",
"telephone_number": "260-451-8242"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOOK-SUPERX LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-02",
"last_updated": "2014-04-22",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "401-765-1500"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201213420A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "1564966",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy# 10190",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fort Wayne, IN
- Jamie Hood
- Jensen Hood, RBT
- Hook- Superx, L.L.C. (CVS Pharmacy # 05696)
- Hook-Superx LLC (CVS Pharmacy # 06737)
- Hook-Superx LLC (CVS Pharmacy # 05369)
- Hook-Superx LLC (CVS Pharmacy #17294)
- Hook-Superx LLC (CVS Pharmacy #06522)
- Hook-Superx LLC (CVS Pharmacy #06520)
- Hook-Superx LLC (CVS Pharmacy # 06479)
- Hook-Superx LLC (CVS Pharmacy #06510)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.