Super Drug Mart Inc
NPI 1679623482ActiveOrganization· Pharmacist· Lytle, TX
Pharmacist in Lytle, Texas, registered in NPPES in January 2007. The authorized official on file is Raymond D. Ibanez, Owner/Pharmacist.
Overview
| NPI | 1679623482 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 12, 2007 |
| Last updated in NPPES | May 19, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacist Primary | 183500000X | 20307 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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