Provider Demographics
NPI:1801004767
Name:SUPERIOR HEART CARE INC
Entity Type:Organization
Organization Name:SUPERIOR HEART CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-486-9100
Mailing Address - Street 1:3900 SUNFOREST CT
Mailing Address - Street 2:SUITE 220
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4475
Mailing Address - Country:US
Mailing Address - Phone:419-486-9100
Mailing Address - Fax:419-885-4792
Practice Address - Street 1:3900 SUNFOREST CT
Practice Address - Street 2:SUITE 220
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4475
Practice Address - Country:US
Practice Address - Phone:419-486-9100
Practice Address - Fax:419-885-4792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064310207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0903482Medicaid
OH01424OtherPARAMOUNT
OH0903482Medicaid
OH01424OtherPARAMOUNT