Superpharm, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

3466 Issued in MA

Legal business name

SUPERPHARM, INC.

Doing business as

Flag Pharmacy

Practice address

7 Willow St
Lynn, MA 01901-1206

Phone

(781) 599-5900

Fax

(781) 599-5918

NPI assigned

Jul 16, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Oleg Urim, RPH

Title

President

Phone

(781) 599-5900

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Flag Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MA2 enrollments

Enrollment records 2

Tax ID family

Superpharm Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Superpharm, Inc.

  dba Flag Pharmacy

  • Long Term Care Pharmacy
  • Lynn, MA
  • NPI 1255892030
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1205853223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WILLOW ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011206",
            "telephone_number": "781-599-5900",
            "fax_number": "781-599-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WILLOW ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011206",
            "telephone_number": "781-599-5900",
            "fax_number": "781-599-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERPHARM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "URIM",
        "authorized_official_first_name": "OLEG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-599-5900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MA",
            "license": "3466",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "3466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "3466",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0407763",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flag Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maureen Sullivan-Hahn, RN
• Elaine Mary Sullivan, LMT
• Joanne Sullivan
• Matt Sullivan
• Sumner Kalman DMD FNC
• Superpharm, Inc. (Flag Pharmacy)
• Eric R Suranski, MA, FAMILY THERAPY
• Leah Surette
• Mary Tatum Surface-Tabbi, C.P.S
• Priyanka Suri

• Community/Retail Pharmacy in Lynn, MA
• Providers in Lynn, MA by specialty
• Community/Retail Pharmacy in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.