Organization
SUPREME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY LEWIS (OWNER)
(515) 943-0122
Entity
Organization
Contact information
Practice address
10002 CATALINA DR, JOHNSTON, IA 50131-3102
(515) 943-0122
Mailing address
10002 CATALINA DR, JOHNSTON, IA 50131-3102
(515) 943-0122
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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