Supreme Healthcare Pllc
Family Medicine Physician in Tulsa, OK(View on Map)
Legal Business Name
Supreme Healthcare Pllc
NPI Number
1326631862
NPI Type
Organization
Enumeration Date
02/16/2021
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
9521 RIVERSIDE PKWY STE B
4619 S HARVARD AVE STE 100
City
Tulsa
Tulsa
State
OK
OK
Postal Code
74137-7422
74135-2921
Country
US
US
Telephone Number
(918) 845-5498
(918) 619-9441
Authorized Official
Name
Mrs. Kandy Keeney
Title or Position
MANAGER
Telephone Number
(918) 845-5498
Identifiers
Identifier
200993730
Identifier State
OK
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 12/15/2021
Provider Address
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