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SUPER DRUG MART
NPI 1679623482
Pharmacist in Lytle, TX

Active since January 12, 2007
19010 PRIEST BLVD, LYTLE, TX 78052(830) 709-0360(830) 709-0363 Get Directions Write a Review

NPPES record last updated: May 19, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Super Drug Mart NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUPER DRUG MART (NPI 1679623482) is a healthcare organization registered as a pharmacist in Lytle, Texas and active in the NPI registry since January 2007. The organization lists Raymond D. Ibanez, Owner/pharmacist, as its authorized official.

NPPES Registry Identity

NPI1679623482
Entity TypeOrganization
Primary Taxonomy183500000X
Legal Business NameSUPER DRUG MART INC
Location Address19010 PRIEST BLVDLytle, TX 78052
Mailing Address19010 Priest Blvd, Suite 101Lytle, TX 78052 · (830) 709-0360 · Fax (830) 709-0363
Phone(830) 709-0360
Fax(830) 709-0363
Organization SubpartNo
Authorized OfficialRaymond D. IbanezOwner/pharmacist · (210) 884-2543
Enumeration DateJanuary 12, 2007
Last NPPES UpdateMay 19, 2015
✔ NPI 1679623482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in TX · 20307
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 modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
19010 PRIEST BLVD, Lytle, TX 78052
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Other Names 1

Doing Business AsSuper Drug Mart

Other Identifiers 3

Medicare NSC1208570001TX
Other20307TX · State Board Of Pharmacy
Medicaid144974TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Super Drug Mart Inc's NPI number?

The NPI number for Super Drug Mart Inc is 1679623482. It was assigned to this organization in the NPPES registry on January 12, 2007. The provider is doing business as Super Drug Mart.

Where is Super Drug Mart Inc located?

Super Drug Mart Inc is located at 19010 Priest Blvd, Lytle, TX 78052. The listed phone number is (830) 709-0360.

What is Super Drug Mart Inc's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Super Drug Mart Inc was last updated on May 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.