Organization
SUPER ROCKWALL DRUGSTORE,LP
Active
Other names
SUPER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARITES TALAVERA SERNA RPH (PRESIDENT)
(972) 772-0500
Entity
Organization
Contact information
Practice address
3021 RIDGE RD, SUITE 103, ROCKWALL, TX 75032-5806
(972) 772-0500
(972) 772-5512
Mailing address
3021 RIDGE RD, SUITE 103, ROCKWALL, TX 75032-5806
(972) 772-0500
(972) 772-5512
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
22390
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145240
—
TX
01
—
22390
TEXAS PHARMACY LICENSE
TX
Enumeration date
02/19/2007
Last updated
03/11/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us