Organization
SUPER PHARMACY LLC
Active
Other names
Super Pharmacy & Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ENOCK K ADEWUYI (CHIEF EXECUTIVE OFFICER)
(202) 388-0050
Entity
Organization
Contact information
Practice address
1019 H ST NE, WASHINGTON, DC 20002-3743
(202) 388-0050
(202) 388-6470
Mailing address
1019 H ST NE, WASHINGTON, DC 20002-3743
(202) 388-0050
(202) 388-6470
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026746500
—
DC
Enumeration date
02/02/2007
Last updated
05/01/2008
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