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General NPI Number Information
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NPI Number | 1073862231
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Entity Type | Organization
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Legal Business Name | SUPREME HELPERS HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 09/04/2012
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Last Update Date | 10/03/2012
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Provider Practice Location Address
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Address Line | 1761 JAMESTOWN ROAD SUITE 103
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-0000
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Country | US
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Telephone | 757-220-2190
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Fax | 757-220-2191
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Provider Business Mailing Address
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Address Line | 1761 JAMESTOWN RD SUITE 103
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-2336
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Country | US
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Telephone | 757-220-2190
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Fax | 757-220-2191
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. JOHN O MADOJEMU
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Credential | MIS, MS, PHD (C)
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Telephone | 757-220-2190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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