Organization
SUPER PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ENOCK K ADEWUYI PHD (CHIEF OPERATING OFFICER)
(202) 388-0050
Entity
Organization
Contact information
Practice address
1019 H ST NE, WASHINGTON, DC 20002-3743
(202) 388-0050
(202) 388-0047
Mailing address
1019 H ST NE, WASHINGTON, DC 20002-3743
(202) 388-0050
(202) 388-0047
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RX9500254
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017028900
—
DC
01
—
0903458
NAPB
—
Enumeration date
08/20/2006
Last updated
03/07/2023
Update your record
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