Organization
HOOK-SUPERX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
13821 LEO RD, LEO CEDARVILLE, IN 46765-9400
(260) 627-8616
Mailing address
ONE CVS DRIVE, BOX 1075-PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
60006047A
IN
333600000X
Pharmacy
Primary
60006047A
IN
3336C0003X
Community/Retail Pharmacy
60006047A
IN
Other
Enumeration date
02/13/2007
Last updated
02/19/2024
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