Provider Demographics
NPI:1922623230
Name:SUPREME CARE MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:SUPREME CARE MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER LLC
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:STOOPS
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:954-979-8371
Mailing Address - Street 1:1700 BANKS RD # 50I
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-7719
Mailing Address - Country:US
Mailing Address - Phone:954-205-6682
Mailing Address - Fax:
Practice Address - Street 1:1700 BANKS RD # 50I
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-7719
Practice Address - Country:US
Practice Address - Phone:954-205-6682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies