Provider Demographics
NPI:1205211992
Name:SUPERIOR MOBILITY LLC
Entity Type:Organization
Organization Name:SUPERIOR MOBILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:
Authorized Official - Last Name:B
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-379-5370
Mailing Address - Street 1:819 GROVE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-2605
Mailing Address - Country:US
Mailing Address - Phone:804-379-5370
Mailing Address - Fax:804-379-5701
Practice Address - Street 1:819 GROVE RD
Practice Address - Street 2:SUITE A
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-2605
Practice Address - Country:US
Practice Address - Phone:804-379-5370
Practice Address - Fax:804-379-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAIR277343800000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)