NPIMap

Organization Active NPI

Super Save Drug

  • Oxygen Equipment & Supplies (DME)
  • Pocatello, ID
National Provider Identifier
1528054830
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
DME197 Issued in ID
Legal business name
SUPER SAVE DRUG
Practice address
701 East Center
Pocatello, ID 83205-4869
Phone
(208) 232-7750
Fax
(208) 233-3343
NPI assigned
Sep 22, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Tori Daniel Shaver
Title
Vice President
Phone
(208) 232-9392

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X DME197 ID Primary

Addresses

Primary practice location

701 East Center
Pocatello, ID 83205-4869

Mailing address

PO Box 4869
701 East Center
Pocatello, ID 83205-4869
Phone (208) 232-7750

National Provider Directory

National Provider Directory
Tax ID family
Super Save Drug2 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.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528054830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4869",
            "address_2": "701 EAST CENTER",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054869",
            "telephone_number": "208-232-7750",
            "fax_number": "208-233-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 EAST CENTER",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054869",
            "telephone_number": "208-232-7750",
            "fax_number": "208-233-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER SAVE DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAVER",
        "authorized_official_first_name": "TORI",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "208-232-9392",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "ID",
            "license": "DME197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.