Provider Demographics
NPI:1336101096
Name:SUPERIOR MEDICAL EQUIP GRP INC
Entity Type:Organization
Organization Name:SUPERIOR MEDICAL EQUIP GRP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-461-4675
Mailing Address - Street 1:PO BOX 1747
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21041-1747
Mailing Address - Country:US
Mailing Address - Phone:410-461-4675
Mailing Address - Fax:410-461-5713
Practice Address - Street 1:3243 BETHANY LANE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042
Practice Address - Country:US
Practice Address - Phone:410-461-4675
Practice Address - Fax:410-461-5713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13209456332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0213710001Medicare ID - Type Unspecified