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Organization
HOOK-SUPERX LLC
Active
Organization
HOOK-SUPERX LLC
Active
Other names
CVS Pharmacy # 03007
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
6010 S EMERSON AVE, INDIANAPOLIS, IN 46237-2901
(317) 783-5325
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENT, 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
—
1564752
NCPDP
IN
05
—
201192800A
—
IN
Enumeration date
07/22/2013
Last updated
02/19/2014
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