Provider Demographics
NPI:1598099954
Name:SUPERIOR HEALTH - CAP SERVICES
Entity Type:Organization
Organization Name:SUPERIOR HEALTH - CAP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:919-693-2464
Mailing Address - Street 1:117 WILLIAMSBORO ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-3328
Mailing Address - Country:US
Mailing Address - Phone:919-693-2464
Mailing Address - Fax:919-693-8860
Practice Address - Street 1:117 WILLIAMSBORO ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-3328
Practice Address - Country:US
Practice Address - Phone:919-693-2464
Practice Address - Fax:919-693-8860
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUPERIOR HEALTH CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418123Medicaid