# SUPER SAVER PHARMACY \#3 LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Super Saver Pharmacy \#3
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679649180
- **Authorized official:** MR. DEVAN MATHURA RPH (MANAGING MEMBER)
- **Authorized official phone:** (321) 284-4631

## Contact information

- **Practice address:** 1901 SOUTH JOHN YOUNG PARKWAY, SUITE 101, KISSIMMEE, FL 34741
- **Practice address phone:** (321) 284-4631
- **Practice address fax:** (407) 518-1134
- **Mailing address:** 1901 SOUTH JOHN YOUNG PARKWAY, SUITE 101, KISSIMMEE, FL 34741
- **Mailing address phone:** (321) 284-4631
- **Mailing address fax:** (407) 518-1134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 333600000X | Pharmacy | PH22086 | FL | — |

## Other

- **Enumeration date:** 11/27/2006
- **Last updated:** 01/18/2008