Provider Demographics
NPI:1144359704
Name:SUPREME HEALTH CARE INC
Entity type:Organization
Organization Name:SUPREME HEALTH CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNEDY
Authorized Official - Middle Name:
Authorized Official - Last Name:NWABUOKU
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:281-499-3444
Mailing Address - Street 1:6200 SAVOY DR STE 510
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3320
Mailing Address - Country:US
Mailing Address - Phone:281-499-3444
Mailing Address - Fax:281-499-9442
Practice Address - Street 1:6200 SAVOY DR STE 510
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3320
Practice Address - Country:US
Practice Address - Phone:281-499-3444
Practice Address - Fax:281-499-9442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX458221Medicare Oscar/Certification