Supreme Health Care Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SUPREME HEALTH CARE INC

Practice address

5701 Kentucky Ave N
Suite 198
Crystal, MN 55428-3370

Phone

(763) 516-7236

Fax

(763) 533-1659

NPI assigned

Jan 29, 2014

Organization subpart

No

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

Authorized official

Name

Zinnah Kollie Chesson

Title

Owner

Phone

(763) 516-7236

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390953600000",
    "number": "1922421841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 KENTUCKY AVE N",
            "address_2": "SUITE 198",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283370",
            "telephone_number": "763-516-7236",
            "fax_number": "763-533-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 KENTUCKY AVE N",
            "address_2": "SUITE 198",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283370",
            "telephone_number": "763-516-7236",
            "fax_number": "763-533-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-01-29",
        "status": "A",
        "authorized_official_last_name": "CHESSON",
        "authorized_official_first_name": "ZINNAH",
        "authorized_official_middle_name": "KOLLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-516-7236"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Lincoln Stewart
• Max Richard Stoltenberg, MC, LPCC
• Gregory Studelska III, ED.S.
• Suite Living Senior Care of Crystal
• Supervalu Pharmacies Inc
• Shavon Swain, LICSW
• Mark Duane Sween, DDS
• Sweendent P.a.
• Ruby Waiyee Tam, D.O.
• Taylor Lawson, LLC

• Primary Care Clinic/Center in Crystal, MN
• Providers in Crystal, MN by specialty
• Primary Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.