Provider Type Icon

SUPER D DRUGS ACQUISITION CO. NPI 1700931458


NPI Information

NPI: 1700931458
Provider Name: SUPER D DRUGS ACQUISITION CO.

Doing Business As: OVERTURF PHARMACY #8434

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
100 MAIN ST
GIDEON, MO
ZIP 63848
Phone: (573) 448-5552
Get Directions

SUPER D DRUGS ACQUISITION CO. is a community/retail pharmacy pharmacy in Gideon, MO. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. SUPER D DRUGS ACQUISITION CO. NPI is 1700931458. The provider is registered as an organization entity type.
The provider Is Doing Business As Overturf Pharmacy #8434.

The provider's business location address is:

100 MAIN ST
GIDEON, MO
ZIP 63848
Phone: (573) 448-5552
Fax: (573) 448-3764

The provider's authorized official is Gary Boone .
The authorized official title is Director Of Hme Operations and has the following contact phone number (479) 394-6363.

The enumeration date for this NPI number is 1/24/2007 and was last updated on 12/17/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336L0003XPharmacyLong Term Care PharmacyNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy005086MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1622745404MEDICAIDMISSOURI
20260980003MEDICARE NSC
32626313OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
4602745408MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.