# SUPER PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871608166
- **Authorized official:** DR. ENOCK K ADEWUYI PHD (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (202) 388-0050

## Contact information

- **Practice address:** 1019 H ST NE, WASHINGTON, DC 20002-3743
- **Practice address phone:** (202) 388-0050
- **Practice address fax:** (202) 388-0047
- **Mailing address:** 1019 H ST NE, WASHINGTON, DC 20002-3743
- **Mailing address phone:** (202) 388-0050
- **Mailing address fax:** (202) 388-0047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RX9500254 | DC | Yes |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 017028900 | — | DC |
| 01 | — | 0903458 | NAPB | — |