Supreme Healthcare LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SUPREME HEALTHCARE LLC

Practice address

2559 Amber St
Philadelphia, PA 19125-1767

Phone

(646) 709-1191

NPI assigned

Mar 23, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Igor Solodky

Title

President

Phone

(646) 709-1191

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1104575307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2559 AMBER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191251767",
            "telephone_number": "646-709-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2559 AMBER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191251767",
            "telephone_number": "646-709-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "SOLODKY",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-709-1191"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.