Provider Demographics
NPI:1457689812
Name:SUPER SAVER PHARMACY 2 LLC
Entity Type:Organization
Organization Name:SUPER SAVER PHARMACY 2 LLC
Other - Org Name:LINDEN CARE ORLANDO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-308-4335
Mailing Address - Street 1:1800 W OAK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-3962
Mailing Address - Country:US
Mailing Address - Phone:407-472-6580
Mailing Address - Fax:407-472-6581
Practice Address - Street 1:1800 W OAK RIDGE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-3962
Practice Address - Country:US
Practice Address - Phone:407-472-6580
Practice Address - Fax:407-472-6581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24341333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2122808OtherPK
FL018629300Medicaid