Provider Demographics
NPI:1265664296
Name:SUPERIOR MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:SUPERIOR MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:T
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LRCP
Authorized Official - Phone:870-364-9346
Mailing Address - Street 1:PO BOX 1381
Mailing Address - Street 2:
Mailing Address - City:CROSSETT
Mailing Address - State:AR
Mailing Address - Zip Code:71635-1381
Mailing Address - Country:US
Mailing Address - Phone:870-364-1500
Mailing Address - Fax:870-364-1502
Practice Address - Street 1:106 RAY LOCHALA RD
Practice Address - Street 2:
Practice Address - City:CROSSETT
Practice Address - State:AR
Practice Address - Zip Code:71635-4542
Practice Address - Country:US
Practice Address - Phone:870-364-1500
Practice Address - Fax:870-364-1502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-08
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR6355080001Medicare NSC