SUPREME WELLNESS RECOVERY SOUTH LLC (NPI# 1164991105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164991105 |
| Entity Type | Organization |
| Organization Name | SUPREME WELLNESS RECOVERY SOUTH LLC |
| Practice Address |
1250 Germantown Pike Plymouth Meeting PA 19462-2444 |
| Mailing Address |
638 Newtown Yardley Rd Ste 1f Newtown PA 18940-1740 |
| Practice Telephone | 2158743636 |
| Mailing Telephone | 2157686186 |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2018-11-20 |
| Authorized Official Name | HUMA MAHMOOD (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2158743636 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 251K00000X | Public Health or Welfare | Agencies |
| Street Address |
1250 GERMANTOWN PIKE |
| City | PLYMOUTH MEETING |
| State | PA |
| Zip Code | 19462-2444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598284192 | Nicole Marie Oconnor Probst | Registered Nurse | 824 Belvoir Road, Plymouth Meeting, PA 19462 | 2017-09-14 |
| 1699299404 | Access Services Inc | Community/Behavioral Health | 4070 Butler Pike Ste 900, Plymouth Meeting, PA 19462 | 2017-08-02 |
| 1255869079 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 615 W Germantown Pike Ste 100, Plymouth Meeting, PA 19462 | 2017-05-24 |
| 1376077545 | Pennsylvania Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2400 Butler Pike, Plymouth Meeting, PA 19462 | 2017-04-14 |
| 1770039604 | David Crowe | Specialist/Technologist | 3045 Arrow Head Lane, Plymouth Meeting, PA 19462 | 2016-08-31 |
| 1881054724 | Urology Health Specialists | Non-Pharmacy Dispensing Site | 400 Davis Road, Suite 200a, Plymouth Meeting, PA 19462 | 2016-03-04 |
| 1578947289 | Amanda Coleen Hassey | Optometrist | 615 W Germantown Pike # 100, Plymouth Meeting, PA 19462 | 2015-07-13 |
| 1902204837 | Janelle Thelma Mcclure | Licensed Practical Nurse | 3113 Jolly Rd., Plymouth Meeting, PA 19462 | 2014-12-09 |
| 1417241860 | Nia Murray | Counselor | 523 Plymouth Rd., Suite215, Plymouthmeeting, PA 19462 | 2011-06-02 |
| 1831496868 | Pamela Faye Knappenberger | Licensed Practical Nurse | 2250 Hickory Rd, Suite 240, Plymouth Meeting, PA 19462 | 2011-02-28 |
| Find all providers in zip 19462 | ||||
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700055985 | Ken-crest Services | Public Health or Welfare | 502 W Germantown Pike, Suite 200, Plymouth Meeting, PA 19462-1348 | 2008-02-21 |
| 1427174119 | General Healthcare Resources, Inc | Public Health or Welfare | 2250 Hickory Rd, Plymouth Meeting, PA 19462-1047 | 2007-03-22 |
| 1144310830 | Silver Springs - Martin Luther School | Public Health or Welfare | 512 Township Line Rd, Plymouth Meeting, PA 19462-1001 | 2006-10-13 |
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| 1265085864 | Access Dentistry, LLC | Public Health or Welfare | 6760 Market St, Upper Darby, PA 19082-2449 | 2019-07-23 |
| 1982164323 | United Community Health Network LLC | Public Health or Welfare | 7804 Montgomery Ave Ste 6, Elkins Park, PA 19027-2649 | 2019-03-21 |
| 1962988618 | Ryan Vass | Public Health or Welfare | 904 Twyckenham Rd, Media, PA 19063-1636 | 2018-07-16 |
| 1902312275 | County of Allegheny | Public Health or Welfare | Department of Human Services Area Agency On Aging, 2100 Wharton Str., 2nd Floor, Pittsburgh, PA 15203-1942 | 2017-12-21 |
| 1679085443 | Warwick Family Based Program Inc | Public Health or Welfare | 1001 Nor Bath Blvd, Northampton, PA 18067-8909 | 2017-11-01 |
| 1013444033 | Loving Care Center, Inc | Public Health or Welfare | 1918 Paul St, Farrell, PA 16121-1324 | 2017-05-22 |
| Find all providers with the same taxonomy | ||||
| City | PLYMOUTH MEETING |
| Zip Code | 19462 |
Please comment or provide details below to improve the information on SUPREME WELLNESS RECOVERY SOUTH LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.