Superco Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

01368/1.1 Issued in MS

Legal business name

SUPERCO INC

Doing business as

Battlefield Discount Drugs

Practice address

3040A Indiana Ave
Vicksburg, MS 39180-4355

Phone

(601) 636-3374

Fax

(601) 638-5376

NPI assigned

Dec 4, 2006

Last updated

Jul 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Storey John, RPH

Title

Owner

Phone

(601) 636-3374

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Battlefield Discount Drugs Doing business as

Locations

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1376601492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040A INDIANA AVE",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "39180",
            "telephone_number": "601-636-3374",
            "fax_number": "601-638-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040A INDIANA AVE",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391804355",
            "telephone_number": "601-636-3374",
            "fax_number": "601-638-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERCO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "STOREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-636-3374",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "01368/1.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2044424",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00095419",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Battlefield Discount Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.