Superior Pharmacy

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

License

054016533 Issued in IL

Legal business name

SUPERIOR PHARMACY

Practice address

356 W Superior St
RM 301-302
Chicago, IL 60654-3416

Phone

(312) 988-7300

NPI assigned

Feb 10, 2009

Organization subpart

No

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

Authorized official

Name

Alan Jackson

Title

Owner

Phone

(773) 619-4102

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Superior Pharmacy Inc Doing business as

Tax ID family

Superior Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Superior Pharmacy Inc

  • Pharmacy
  • Chicago, IL
  • NPI 1891934436
  NPD tax ID

Locations

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234224000000",
    "number": "1942449335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 W SUPERIOR ST",
            "address_2": "RM 301-302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 W SUPERIOR ST",
            "address_2": "RM 301-302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543416",
            "telephone_number": "312-988-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-10",
        "last_updated": "2009-02-10",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-619-4102"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "IL",
            "license": "054016533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1482912",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edward John Supan, PA-C
• Panjaporn Supanwanid Henrich, M.D.
• Super Therapy Clinic LTD
• Riccardo Superina, MD
• Superior Orthopedics, Inc.
• Superior Pharmacy Inc
• Superior Physician Services Il LLC
• Superior Rehab Center LLC
• Superior RX Inc.
• Superior Therapy & Counseling Services LLC

• Mail Order Pharmacy in Chicago, IL
• Providers in Chicago, IL by specialty
• Mail Order Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.