Provider Demographics
NPI:1396818316
Name:SUPERIOR HEALTHCARE PLLC
Entity Type:Organization
Organization Name:SUPERIOR HEALTHCARE PLLC
Other - Org Name:SWIFT REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMININSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-783-8977
Mailing Address - Street 1:2839 W KENNEWICK AVE # 550
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2927
Mailing Address - Country:US
Mailing Address - Phone:509-783-8977
Mailing Address - Fax:509-783-6151
Practice Address - Street 1:4303 W 27TH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-1986
Practice Address - Country:US
Practice Address - Phone:509-783-8977
Practice Address - Fax:509-783-6151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB33062Medicare PIN