Provider Demographics
NPI:1689214454
Name:SUPERIOR HEALTHCARE PLLC
Entity Type:Organization
Organization Name:SUPERIOR HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENTON
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-368-1376
Mailing Address - Street 1:7560 US HIGHWAY 42 STE B
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1908
Mailing Address - Country:US
Mailing Address - Phone:859-283-2475
Mailing Address - Fax:
Practice Address - Street 1:7560 US HIGHWAY 42 STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1908
Practice Address - Country:US
Practice Address - Phone:859-283-2475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty