NPIMap

Organization Active NPI

Hook-Superx LLC

  • Community/Retail Pharmacy
  • Evansville, IN
National Provider Identifier
1306881313
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HOOK-SUPERX LLC
Doing business as
CVS Pharmacy #18079
SCHNUCKS PHARMACY
Practice address
5000 Washington Ave
Evansville, IN 47715-4812
Phone
(812) 473-0113
Fax
(812) 473-0114
NPI assigned
Jun 17, 2006
Organization subpart
Yes
Parent organization
SCHNUCK MARKETS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Authorized official

Name
Susan F Colbert
Title
Sr. Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WD0400X
Medical Specialty Clinic/Center 261QM2500X
Durable Medical Equipment & Medical Supplies 332B00000X 60002429A IN
Pharmacy 333600000X 60002429A IN
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

5000 Washington Ave
Evansville, IN 47715-4812

Mailing address

1 CVS Dr # 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 2

IdentifierTypeStateIssuer
100308290AMedicaidIN
1517931OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 2

  • CVS Pharmacy #18079 Doing business as
  • SCHNUCKS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101018000112 IN Part B Supplier - Mass Immunization (Roster Biller Only) 1658310602 This NPI is an additional NPI on the enrollment
Practice locations: Indianapolis, IN
O20201020001780 IN DME Supplier - Pharmacy 1658310602 Practice locations: Evansville, IN

Laboratory certificates & supplier records

Derived by NPIMap

These 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

SupplierSuppliesMedicare assignment
Hook-Superx LLC5000 Washington Ave, Evansville, IN 47715-4812(812) 473-0113 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 assignmentParticipating since Jan 1, 2025

National Provider Directory

National Provider Directory
Tax ID family
Super X Drugs VA-065 Ipl300 organizations share this tax ID, including this one
Part of
Schnucks Pharmacy 711

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.

View all 24

Member of 1

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

Locations

5000 Washington Ave
Evansville, IN 47715
Phone (812) 473-0113

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1306881313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR # 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154812",
            "telephone_number": "812-473-0113",
            "fax_number": "812-473-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOOK-SUPERX LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCHNUCK MARKETS INC",
        "enumeration_date": "2006-06-17",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "60002429A",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IN",
            "license": "60002429A",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100308290A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1517931",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #18079",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SCHNUCKS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SCHNUCKS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.

Verify at the official NPI Registry.