Provider Demographics
NPI:1811238827
Name:SUPERIOR BATH SYSTEMS
Entity Type:Organization
Organization Name:SUPERIOR BATH SYSTEMS
Other - Org Name:BATH PLANET OF ROANOKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:SPRINGSTEADAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-387-1200
Mailing Address - Street 1:1221 SOUTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-4605
Mailing Address - Country:US
Mailing Address - Phone:540-387-1200
Mailing Address - Fax:540-387-1205
Practice Address - Street 1:1221 SOUTHSIDE DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-4605
Practice Address - Country:US
Practice Address - Phone:540-387-1200
Practice Address - Fax:540-387-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705148566332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment