Super 1 Foods Pharmacy #642

Pharmacy Accepts Medicare


  
  172 Centennial Pkwy, Tyler
Texas, 75703

 903-525-6923    903-581-2421
Super 1 Foods Pharmacy #642 is a Pharmacy in Tyler, Texas. This pharmacy is owned and operated by Brookshire Grocery Company. It is located at 172 Centennial Pkwy, Tyler and it's customer support contact number is 903-525-6923. The authorized person of Super 1 Foods Pharmacy #642 is Jim Cousineau who is Senior Vp Pharmacy Operations of the pharmacy and his contact number is 903-877-6829. Active license number of Super 1 Foods Pharmacy #642 is 30243 for Pharmacy in Texas. Super 1 Foods Pharmacy #642 accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Super 1 Foods Pharmacy #642 is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Pharmacy Details:
Super 1 Foods Pharmacy #642 type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
Name: Super 1 Foods Pharmacy #642
Type: Pharmacy
Location:172 Centennial Pkwy, Tyler,
Texas, 75703
Phone:903-525-6923
Fax:903-581-2421
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
Name: Jim Cousineau
Position: Senior Vp Pharmacy Operations
Contact Number: 903-877-6829
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
NPI Number: 1962874602
NPI Enumeration Date: 21 Oct, 2015
NPI Last Update On: 21 Sep, 2016

Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Super 1 Foods Pharmacy #642 are as mentioned below.
SpecializationLicense NumberStateStatus
Pharmacy 30243TexasPrimary
Community/Retail Pharmacy Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
IdentifierTypeStateIssuer
2154729OtherPk
470992MedicaidTexas
Medicare Enrollment:
Super 1 Foods Pharmacy #642 is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
PAC ID: Enrollment ID: Org NameMedicare Entity Type
1355415712O20160802002852Brookshire Grocery CompanyDME SUPPLIER - PHARMACY
Products Available:
Super 1 Foods Pharmacy #642 has following products available for sale under medicare.
    Products
  • Blood Glucose Monitors & Supplies: Non-mail Order
  • Canes & Crutches
  • Commodes, Urinals, & Bedpans
  • Heat & Cold Applications
  • Nebulizer Equipment & Supplies
  • Orthoses: Off-the-shelf
  • Surgical Dressings
  • Walkers
  • Business Mailing Address:
    Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
    Address: Po Box 1411, Attention Pharmacy Department
    Tyler, Texas
    Zip: 75710-1411
    Phone Number: 903-877-6862
    Fax Number: 903-877-3820
    Patients can reach Super 1 Foods Pharmacy #642 at 172 Centennial Pkwy, Tyler, Texas or can call on customer care at 903-525-6923.

    Comments/ Reviews:


    *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 November, 2024.

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