# SUPER D DRUG ACQUISITION CO., INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vital Care of Oxford
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881629780
- **Authorized official:** GARY BOONE (PRESIDENT)
- **Authorized official phone:** (662) 234-7666

## Contact information

- **Practice address:** 1201 OFFICE PARK DR, SUITE 2, OXFORD, MS 38655-3598
- **Practice address phone:** (662) 234-7666
- **Practice address fax:** (662) 236-1211
- **Mailing address:** PO BOX 5047, MERIDIAN, MS 39302-5047
- **Mailing address phone:** (800) 447-4095
- **Mailing address fax:** (601) 482-7490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 04340/02.1 | MS | — |
| 332BC3200X | Customized Equipment (DME) | 04340/02.1 | MS | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | 04340/02.1 | MS | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 04340/02.1 | MS | — |
| 333600000X | Pharmacy | 04340/02.1 | MS | — |
| 3336C0003X | Community/Retail Pharmacy | 04340/02.1 | MS | — |
| 3336H0001X | Home Infusion Therapy Pharmacy | 04340/02.1 | MS | — |
| 3336L0003X | Long Term Care Pharmacy | 04340/02.1 | MS | — |
| 3336M0002X | Mail Order Pharmacy | 04340/02.1 | MS | — |
| 3336S0011X | Specialty Pharmacy | 04340/02.1 | MS | Yes |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00040337 | — | MS |
| 05 | — | 00330376 | — | MS |
| 01 | — | 640870044003 | CHAMPUS/TRICARE | — |