Hook-Superx LLC
Organization Active NPI Pharmacy · Nappanee, IN
NPI 1609979392 · NPPES record last updated Feb 19, 2024
Key facts
- NPI
- 1609979392
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 60004490A (IN)
- Legal business name
- HOOK-SUPERX LLC
- Practice address
- 1534 E Market St
Nappanee, IN 46550-2300 - Phone
- (574) 773-4311
- NPI assigned
- Sep 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan Colbert
- Title
- Director, Payer Relations
- Phone
- (401) 770-2751
Corporate family (same tax ID) 24
Member of 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930038798 | IN | DME Supplier - Pharmacy | 1658310602 | Practice locations: Nappanee, IN |
| O20101018000112 | IN | Part B Supplier - Mass Immunization (Roster Biller Only) | 1658310602 |
This NPI is an additional NPI on the enrollment Practice locations: Indianapolis, IN |
National Provider Directory
- Tax ID family
- Super X Drugs VA-065 Ipl
Locations
1534 E Market St
Nappanee, IN 46550
Phone (574) 773-4311
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 60004490A | IN | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1534 E Market St
Nappanee, IN 46550-2300
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1506976 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- CVS PHARMACY #06467
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Other providers in Nappanee, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.