Provider Demographics
NPI:1073862231
Name:SUPREME HELPERS HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:SUPREME HELPERS HEALTHCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:O
Authorized Official - Last Name:MADOJEMU
Authorized Official - Suffix:
Authorized Official - Credentials:MIS, MS, PHD (C)
Authorized Official - Phone:757-220-2190
Mailing Address - Street 1:1761 JAMESTOWN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2336
Mailing Address - Country:US
Mailing Address - Phone:757-220-2190
Mailing Address - Fax:757-220-2191
Practice Address - Street 1:1761 JAMESTOWN ROAD
Practice Address - Street 2:SUITE 103
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-0000
Practice Address - Country:US
Practice Address - Phone:757-220-2190
Practice Address - Fax:757-220-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-04
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies