Organization
HOOK-SUPERX LLC
Active
Other names
CVS PHARMACY # 10176
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR- PAYER RELATIONS)
(701) 765-1500
Entity
Organization
Contact information
Practice address
10 EAST 81ST AVE, MERRILLVILLE, IN 46410
(219) 769-0013
Mailing address
ONE CVS DRIVE, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
IN
333600000X
Pharmacy
Primary
—
IN
3336C0003X
Community/Retail Pharmacy
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1567443
NCPDP
IN
05
—
201389980
—
IN
Enumeration date
06/07/2016
Last updated
02/19/2024
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