Provider Demographics
NPI:1306968136
Name:SUPREME SOLUTIONS INC
Entity type:Organization
Organization Name:SUPREME SOLUTIONS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-366-3402
Mailing Address - Street 1:301 MOUNT HOPE AVE
Mailing Address - Street 2:SUITE 2043
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-2130
Mailing Address - Country:US
Mailing Address - Phone:973-366-3402
Mailing Address - Fax:973-366-5072
Practice Address - Street 1:301 MOUNT HOPE AVE
Practice Address - Street 2:SUITE 2043
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-2130
Practice Address - Country:US
Practice Address - Phone:973-366-3402
Practice Address - Fax:973-366-5072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00318701332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier