Organization
SUPREME HEALTH CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN OMONKHUALE MADOJEMU MSM, PHD (C) (PROGRAM DIRECTOR)
(757) 393-0327
Entity
Organization
Contact information
Practice address
3300 TYRE NECK ROAD, SUITE F, PORTSMOUTH, VA 23703-3319
(757) 393-0327
(757) 393-0328
Mailing address
3300 TYRE NECK ROAD, SUITE F, PORTSMOUTH, VA 23703-3319
(757) 393-0327
(757) 393-0328
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
314000000X
Skilled Nursing Facility
—
—
3140N1450X
Pediatric Skilled Nursing Facility
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
08/30/2007
Last updated
08/03/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us