NPIMap

Organization Active NPI

Super D Drugs Acquisition Co

  • Pharmacy
  • Pine Bluff, AR
National Provider Identifier
1992042964
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SUPER D DRUGS ACQUISITION CO
Practice address
3022 N Midland Dr
Pine Bluff, AR 71603-4829
Phone
(217) 709-2386
NPI assigned
Jan 11, 2013
Organization subpart
Yes
Parent organization
WALGREEN COAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Authorized official

Name
Kermit R Crawford
Title
President
Phone
(847) 315-3154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

3022 N Midland Dr
Pine Bluff, AR 71603-4829

Mailing address

1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2386

National Provider Directory

National Provider Directory
Tax ID family
Super D Drugs Acquisition Co25 organizations share this tax ID, including this one
Part of
Walgreens 16466

Other organizations with this tax ID 24

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

View all 24

Locations

3022 N Midland Dr
Pine Bluff, AR 71603

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1992042964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST",
            "address_2": "MS 790",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618344509",
            "telephone_number": "217-709-2386",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3022 N MIDLAND DR",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034829",
            "telephone_number": "217-709-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER D DRUGS ACQUISITION CO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREEN CO",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "KERMIT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-315-3154"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; 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.