SUPER G PHARMACY 388 – Community/Retail Pharmacy, NPI 1992738249
Community/Retail Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for SUPER G PHARMACY 388
1000, Northeast 178th Avenue, Rockwood, Portland, Metro, Multnomah County, Oregon, 97230, United States
MS 3000
PORTLAND, ME 041045005
Phone: (207) 885-7454
Fax: (704) 645-6531
Type: Mailing
200, Dove Run Centre Drive, Middletown, New Castle County, Delaware, 19709, United States
MIDDLETOWN, DE 197097971
Phone: (302) 828-9181
Fax: (302) 828-9190
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation scheduled
Earliest CMS due date is 2026-10-31 (142 days away).
Enrollment records
1
Earliest due date
2026-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100930082428 | O | Pharmacy | DE | 2026-10-31 |
What to do next
- Monitor the published due date as it approaches.
- Plan to revalidate in PECOS within the window CMS allows before the due date.
- Verify the date on the CMS Revalidation Lookup Tool before submitting.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 255 | 252 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 189 | 188 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 163 | 163 | $0 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 82 | 82 | $0 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 81 | 81 | $0 |
Insurance plans in this area (ZIP 04104)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.