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Organization
SUPREME PHARMACY INC.
Active
Organization
SUPREME PHARMACY INC.
Active
Other names
Queen Mary Pharmacy, SOUTHERN BLVD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KRUPA SANNIDHI (OWNER)
(718) 282-2000
Entity
Organization
Contact information
Practice address
990 SOUTHERN BLVD, BRONX, NY 10459-3402
(718) 282-2000
(718) 282-0222
Mailing address
990 SOUTHERN BLVD, BRONX, NY 10459-3402
(718) 282-2000
(718) 282-0222
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06075896
—
NY
Enumeration date
12/04/2019
Last updated
11/10/2025
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