# SUPER D DRUGS ACQUISITION CO.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** SUPER D DRUGS \#139
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306929922
- **Authorized official:** MR. CHAD COOPER (DIRECTOR OF HME OPERATIONS)
- **Authorized official phone:** (501) 296-3337

## Contact information

- **Practice address:** 3012 HIGHWAY 80 E, PEARL, MS 39208-3497
- **Practice address phone:** (601) 939-4813
- **Practice address fax:** (601) 939-2749
- **Mailing address:** 2100 BROOKWOOD DR, LITTLE ROCK, AR 72202-1734
- **Mailing address phone:** (501) 296-3337
- **Mailing address fax:** (501) 296-3310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 01918012 | MS | — |
| 333600000X | Pharmacy | 01918/01.2 | MS | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/24/2006
- **Last updated:** 01/26/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00330375 | — | MS |
| 01 | — | 00440585 | MEDICAID DME | MS |
| 01 | — | 2514506 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | 330375 | — | MS |
| 01 | — | 870001323 | MEDICARE FLU | MS |