Provider Demographics
NPI:1225294184
Name:SUPERIOR MEDICAL APPLICATIONS
Entity Type:Organization
Organization Name:SUPERIOR MEDICAL APPLICATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:WATSON
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-497-7655
Mailing Address - Street 1:14120 HIGHWAY 210 SOUTH
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NC
Mailing Address - Zip Code:28390-9432
Mailing Address - Country:US
Mailing Address - Phone:910-497-7655
Mailing Address - Fax:910-497-7658
Practice Address - Street 1:14120 HIGHWAY 210 SOUTH
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NC
Practice Address - Zip Code:28390-9432
Practice Address - Country:US
Practice Address - Phone:910-497-7655
Practice Address - Fax:910-497-7658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies