Organization
SUPREME HOME HEALTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMILY B WINSTON R.N. (C.E.O.)
(318) 325-8863
Entity
Organization
Contact information
Practice address
1110 JACKSON ST, MONROE, LA 71202-2024
(318) 323-5489
(318) 323-8602
Mailing address
1110 JACKSON ST, PO BOX 3145, MONROE, LA 71202-2024
(318) 323-5489
(318) 323-8602
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
121
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10525
INFLUENZA VACCINE
LA
05
—
140095
—
LA
01
—
1930033530Z
BLUE CROSS BLUE SHIELD KE
LA
01
—
33530
BLUE CROSS BLUE SHIELD
LA
01
—
H83053
VANTAGE HEALTH PLAN, INC.
LA
Enumeration date
09/20/2006
Last updated
08/22/2020
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