1497009112 NPI number — SUPERIOR MEDICAL EQUIPMENT GROUP, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497009112 NPI number — SUPERIOR MEDICAL EQUIPMENT GROUP, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUPERIOR MEDICAL EQUIPMENT GROUP, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497009112
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1747
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLICOTT CITY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21041-1747
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-461-4675
Provider Business Mailing Address Fax Number:
410-461-5424

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
59 N. 7TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-2746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-709-4731
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ROUEN
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
LAWRENCE
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
410-461-4675

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 193728600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com