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Provider Information for 1588767925


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HOOK-SUPERX LLC

Other Names:  
Doing Business As: 
CVS PHARMACY #06602

Organization Subpart: NO

NPI: 1588767925
Last Updated: 2024-02-19
Certification Date: 2024-02-19

Details

NameValue
NPI1588767925
Enumeration Date2006-09-07
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: SUSAN COLBERT
Title: Director, Payer Relations
Phone: 4017702751
Mailing Address 1 CVS DR
PO BOX 1075
WOONSOCKET, RI 02895-6146
United States

Phone: 401-765-1500 | Fax:
 
Primary Practice Address 11588 ALLISONVILLE RD
FISHERS, IN 46038-1846
United States

Phone: 317-842-7773 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)1519315Other ID Number-Commercial Number
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 332B00000X - Durable Medical Equipment & Medical Supplies
No 3336C0003X - Pharmacy - Community/Retail Pharmacy
Yes 333600000X - Pharmacy IN60004710A