Hook-Superx LLC
Organization Active NPI Pharmacy · Versailles, IN
NPI 1831292556 · NPPES record last updated Feb 19, 2024
Key facts
- NPI
- 1831292556
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 60004685A (IN)
- Legal business name
- HOOK-SUPERX LLC
- Practice address
- 221 S High St
Versailles, IN 47042-0000 - Phone
- (812) 689-5553
- NPI assigned
- Sep 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan F Colbert
- Title
- Director, Payer Relations
- Phone
- (401) 770-5721
Corporate family (same tax ID) 24
Member of 1
Practitioners 4
-
Michele L Scudder, RPH
-
Alexandra Thurnall, PHARMD
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Hook-Superx LLC |
Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930076991 | IN | DME Supplier - Pharmacy | 1658310602 | Practice locations: Versailles, 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
1006 S Adams St
Versailles, IN 47042
221 S High St
Versailles, IN 47042
Phone (812) 689-5553
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 60004685A | IN | |
| Pharmacy | 333600000X | 60004685A | IN | Yes |
| Community/Retail Pharmacy | 3336C0003X | 60004685A | IN |
Addresses
Primary practice location
221 S High St
Versailles, IN 47042-0000
Mailing address
PO Box 1075
1 CVS Dr
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1524835 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- CVS PHARMACY #06814
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 Versailles, 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.