Hook-Superx LLC
Organization Active NPI Pharmacy · Fort Wayne, IN
NPI 1245330554 · NPPES record last updated Aug 24, 2016
Key facts
- NPI
- 1245330554
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- HOOK-SUPERX LLC
- Practice address
- 3801 Coldwater Rd
Fort Wayne, IN 46805-1101 - Phone
- (260) 470-6361
- Fax
- (260) 470-6371
- NPI assigned
- Sep 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan Colbert
- Title
- Sr. Director, Payer Relations
- Phone
- (401) 770-2751
Corporate family (same tax ID) 24
Member of 1
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Hook-Superx LLC |
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 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN
Medicare enrollment records
| 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 |
| O20160324001842 | IN | DME Supplier - Pharmacy | 1658310602 | Practice locations: Fort Wayne, IN |
National Provider Directory
- Tax ID family
- Super X Drugs VA-065 Ipl
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Yes | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
3801 Coldwater Rd
Fort Wayne, IN 46805-1101
Mailing address
1 CVS Dr
Mail Code 1090
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200844790A | Medicaid | IN | |
| 2025470 | Other | PK |
Other names
- CVS Pharmacy #17294
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.