Organization
SUPER D DRUGS ACQUISITION CO
Active
Other names
Overturf Pharmacy DME #8437
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD COOPER (PHARMACY SERVICES COORDINATOR)
(501) 296-3337
Entity
Organization
Contact information
Practice address
907 WEST BUSINESS HWY. 60, DEXTER, MO 63841
(573) 624-6968
(573) 624-3635
Mailing address
2100 BROOKWOOD DR, LITTLE ROCK, AR 72202-1734
(479) 394-6363
(479) 394-1046
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
038398
MO
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
038398
MO
332BX2000X
Oxygen Equipment & Supplies (DME)
038398
MO
Other
Enumeration date
01/22/2010
Last updated
12/10/2010
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