Super Drug Mart Inc in Lytle - Pharmacist
Super Drug Mart Inc - NPI 1679623482
Super Drug Mart Inc is a Pharmacist in Lytle, Texas. Super Drug Mart Inc practices all healthcare services and medical treatments related to Pharmacist. The NPI Number for Super Drug Mart Inc is 1679623482. The last update date is 2015-05-19.
Super Drug Mart Inc's current location address is 19010 Priest Blvd, Lytle, Texas. You can contact this provider via phone number 8307090360 and fax number 8307090363. The mailing address for Super Drug Mart Inc is 19010 Priest Blvd, Lytle, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Super Drug Mart Inc |
|---|---|
| Address | 19010 Priest Blvd, Lytle, Texas |
| Phone Number | 8307090360 |
| Fax Number | 8307090363 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/PHAR |
|---|---|
| Authorized Official Name | Ibanez D. Raymond |
| Telephone Number | 2108842543 |
NPI Number Detail
| NPI Number | 1679623482 |
|---|---|
| Provider Enumeration Date | 2007-01-12 |
| Last Updated Date | 2015-05-19 |
Provider Mailing Address Detail
| Address | 19010 Priest Blvd |
|---|---|
| City | Lytle |
| State | Texas (TX) |
| Post Code | 78052 |
| Phone Number | 8307090360 |
| Fax Number | 8307090363 |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacist |
|---|---|
| Taxonomy | 183500000X |
| Licence No | 20307 |
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Definition: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or m |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 20307 | TX | STATE BOARD OF PHARMACY | |
| 144974 | TX | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Super Drug Mart Inc by the Centers for Medicare & Medicaid Services?
The Super Drug Mart Inc has been issued the NPI (National Provider Identifier) 1679623482, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Super Drug Mart Inc's facilities are situated?
The facilities of Super Drug Mart Inc are physically located at the following address: 19010 Priest Blvd, Lytle, TX, 78052.
What is Super Drug Mart Inc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Super Drug Mart Inc's area of specialization is Pharmacist, and the corresponding taxonomy code that categorizes this field of practice is 183500000X.
On what date was the 1679623482 assigned to Super Drug Mart Inc?
The Super Drug Mart Inc was issued its 1679623482 on 2007-01-12, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Super Drug Mart Inc, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Super Drug Mart Inc, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2015-05-19.