Supreme Pharmacy and Medical Supplies LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P04318 Issued in MD

Legal business name

SUPREME PHARMACY AND MEDICAL SUPPLIES LLC

Practice address

7936 Johnson Ave
Glenarden, MD 20706-1772

Phone

(301) 322-8082

Fax

(301) 322-8481

NPI assigned

May 27, 2006

Organization subpart

No

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

Authorized official

Name

Alpesh Patel

Title

Owner

Phone

(813) 304-2221

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kafi B Agboola

  • Pharmacist
  • Glenarden, MD
  • NPI 1841269990
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1598712481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5908 BRECKENRIDGE PARKWAY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33610",
            "telephone_number": "813-304-2221",
            "fax_number": "888-239-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7936 JOHNSON AVE",
            "city": "GLENARDEN",
            "state": "MD",
            "postal_code": "207061772",
            "telephone_number": "301-322-8082",
            "fax_number": "301-322-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME PHARMACY AND MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "ALPESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-304-2221"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P04318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408693700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2038096",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danteh Sema
• Zoe Toma Sherman
• Nimi Sikri, OD
• Siloam Health Support Services Inc
• Natalie Sorek, PT, DPT
• Ange Lydie Tchouaga, DDS
• Nicasius Tendong-Keng
• Olaide Olufunmilay Tomiye
• You First Health Systems, LLC
• Kelly Ngimnkia Djoubou Younti

• Community/Retail Pharmacy in Glenarden, MD
• Providers in Glenarden, MD by specialty
• Community/Retail Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.