Provider Demographics
NPI:1891476800
Name:SUPERIOR PHARMACY LLC
Entity Type:Organization
Organization Name:SUPERIOR PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:262-649-3900
Mailing Address - Street 1:3920 S 27TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53221-1826
Mailing Address - Country:US
Mailing Address - Phone:262-649-3900
Mailing Address - Fax:262-649-3076
Practice Address - Street 1:3920 S 27TH ST STE A
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53221-1826
Practice Address - Country:US
Practice Address - Phone:262-649-3900
Practice Address - Fax:262-649-3076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy