Organization
HOOK-SUPERX LLC
Active
Other names
CVS Pharmacy # 10173
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
367 W 116TH ST, CARMEL, IN 46032-3287
(317) 574-0145
Mailing address
1 CVS DR, BOX - 1075 - PHARMACY ENROLLMENTS, 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
—
1564764
NCPDP
IN
Enumeration date
07/22/2013
Last updated
12/31/2013
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