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Organization
HOOK-SUPERX LLC
Active
Organization
HOOK-SUPERX LLC
Active
Other names
CVS Pharmacy # 03975
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (EXEC DIR, RX SERVICES)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1002 SPRING ST, JEFFERSONVILLE, IN 47130-3641
(812) 282-2256
Mailing address
1 CVS DR, BOX 1075- PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1563332
NCPDP
IN
05
—
201028380A
—
IN
05
—
7100182070
—
KY
Enumeration date
06/02/2011
Last updated
01/13/2023
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