Provider Demographics
NPI:1972718856
Name:SUPERIOR MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:SUPERIOR MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MALAYSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-885-5715
Mailing Address - Street 1:810 EASTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7640
Mailing Address - Country:US
Mailing Address - Phone:336-885-5715
Mailing Address - Fax:336-885-7036
Practice Address - Street 1:810 EASTCHESTER DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7640
Practice Address - Country:US
Practice Address - Phone:336-885-5715
Practice Address - Fax:336-885-7036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-13
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC149974332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704427Medicaid
NC5626320001Medicare NSC