Organization
SUPREME PHARMACY AND MEDICAL SUPPLIES LLC
Active
Organization
SUPREME PHARMACY AND MEDICAL SUPPLIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALPESH PATEL (OWNER)
(813) 304-2221
Entity
Organization
Contact information
Practice address
7936 JOHNSON AVE, GLENARDEN, MD 20706-1772
(301) 322-8082
(301) 322-8481
Mailing address
5908 BRECKENRIDGE PARKWAY, TAMPA, FL 33610
(813) 304-2221
(888) 239-8423
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P04318
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2038096
PK
—
05
—
408693700
—
MD
Enumeration date
05/27/2006
Last updated
10/24/2018
Update your record
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