Provider Demographics
NPI:1861832172
Name:SUPERIOR MAINTENANCE SUPPLY LLC
Entity Type:Organization
Organization Name:SUPERIOR MAINTENANCE SUPPLY LLC
Other - Org Name:1STOP MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:P
Authorized Official - Last Name:BRAND
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:516-242-2424
Mailing Address - Street 1:20 NORTH MALL
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803
Mailing Address - Country:US
Mailing Address - Phone:516-249-2424
Mailing Address - Fax:516-249-2426
Practice Address - Street 1:20 NORTH MALL
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803
Practice Address - Country:US
Practice Address - Phone:516-249-2424
Practice Address - Fax:516-249-2426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies