NPIMap

Organization Active NPI

Super D Drug Acquisition Co

Doing business as Star Pharmacy

  • Community/Retail Pharmacy
  • Osceola, AR
National Provider Identifier
1609911338
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR05399 Issued in AR
Legal business name
SUPER D DRUG ACQUISITION CO
Doing business as
Star Pharmacy
Practice address
916 W Keiser Ave
Osceola, AR 72370-2912
Phone
(500) 296-3337
Fax
(501) 296-3310
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Chad Cooper
Title
Pharmacy Services Coordinator
Phone
(501) 296-3337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X AR05399 AR Primary

Addresses

Primary practice location

916 W Keiser Ave
Osceola, AR 72370-2912

Mailing address

916 W Keiser Ave
Osceola, AR 72370-2912
Phone (501) 296-3337

Other identifiers 3

IdentifierTypeStateIssuer
0405399OtherARNCDPD OR NAPB NUMBER
100466407MedicaidAR
117355716MedicaidAR

Other names 1

  • Star Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Super D Drugs Acquisition Co25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1609911338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 W KEISER AVE",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723702912",
            "telephone_number": "501-296-3337",
            "fax_number": "501-296-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 W KEISER AVE",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723702912",
            "telephone_number": "500-296-3337",
            "fax_number": "501-296-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER D DRUG ACQUISITION CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "PHARMACY SERVICES COORDINATOR",
        "authorized_official_telephone_number": "501-296-3337"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR05399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCDPD OR NAPB NUMBER",
            "identifier": "0405399",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100466407",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117355716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Star Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osceola, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.