Super D Drug Acquisition Co.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SUPER D DRUG ACQUISITION CO.

Doing business as

USA DRUG EXPRESS #1006

Practice address

4010 W 12TH St
Little Rock, AR 72204-2047

Phone

(501) 663-9497

Fax

(501) 664-5019

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary M. Boone

Title

Director of HME Operations

Phone

(479) 394-6363

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• USA DRUG EXPRESS #1006 Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Walgreen Co

  • Pharmacy
  • South Chicago Heights, IL
  • NPI 1538175096

  Member Of

  NPD member

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1275616682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 BROOKWOOD DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722021734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 W 12TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722042047",
            "telephone_number": "501-663-9497",
            "fax_number": "501-664-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER D DRUG ACQUISITION CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIRECTOR OF HME OPERATIONS",
        "authorized_official_telephone_number": "479-394-6363",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "AR20066",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AR",
            "license": "AR20066",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FLU",
            "identifier": "10615",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "135607716",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0401048",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133660407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USA DRUG EXPRESS #1006",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sunder Krishnan, MD, PLLC
• Khristian Marc Sunga, MD
• Chirag Sunil Lalwani, MBBS
• Anusha Sunkara, MD
• Nikita Sunny, MBBS
• Super D. Drugs Acquisition Co.
• Grace Lillian Super
• Superior Source Inc
• Superior Touch Massage Clinic
• Supermarket Investors Inc

• Community/Retail Pharmacy in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.