Hook-Superx LLC
Organization Active NPI Pharmacy · West Baden Springs, IN
NPI 1922101641 · NPPES record last updated Feb 19, 2024
Key facts
- NPI
- 1922101641
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 60004739A (IN)
- Legal business name
- HOOK-SUPERX LLC
- Practice address
- 8321 W State Road 56
West Baden Springs, IN 47469-9655 - Phone
- (812) 936-7272
- NPI assigned
- Sep 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan F Colbert
- Title
- Director, Payer Relations
- Phone
- (401) 770-2751
Corporate family (same tax ID) 24
Member of 1
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930039111 | IN | DME Supplier - Pharmacy | 1658310602 | Practice locations: West Baden Springs, 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
8512 W State Road 56
French Lick, IN 47432
8321 W State Road 56
West Baden Springs, IN 47469
Phone (812) 936-7272
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 60004739A | IN | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
8321 W State Road 56
West Baden Springs, IN 47469-9655
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100305890A | Medicaid | IN | |
| 1524671 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- CVS PHARMACY #06884
Other providers in West Baden Springs, IN
- Kelly Albright
- Rebekah Kaylene Beaty
- Hawkins Health Center of French Lick, LLC
- Heather Kearby
- Stephanie McGuire
- Brenda Kay Painter
- Carrie Ann Smith
- Southern Indiana Community Health Care, Inc
All providers in West Baden Springs, IN · Pharmacy in Indiana
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.