Organization Active NPI

Superx Pharmacy LLC

  • Pharmacy
  • Oklahoma City, OK
National Provider Identifier
1619698370
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SUPERX PHARMACY LLC
Practice address
2668 N Military Ave
Oklahoma City, OK 73106-5639
Phone
(405) 674-6345
Fax
(405) 676-6138
NPI assigned
Sep 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
Dr. Tran Nguyen, PHARMDNPI 1669753422
Title
Owner
Phone
(405) 408-5210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

2668 N Military Ave
Oklahoma City, OK 73106-5639

Mailing address

2668 N Military Ave
Oklahoma City, OK 73106-5639
Phone (405) 408-5210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230606000771 OK Part B Supplier - Pharmacy 0749647865 Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

2668 N Military Ave
Oklahoma City, OK 73106
Phone (405) 674-6345

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1619698370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2668 N MILITARY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731065639",
            "telephone_number": "405-408-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2668 N MILITARY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731065639",
            "telephone_number": "405-674-6345",
            "fax_number": "405-676-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERX PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-09",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "TRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-408-5210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.