Provider Demographics
NPI:1255574430
Name:SUPERIOR MEDICAL SERVICES INC
Entity type:Organization
Organization Name:SUPERIOR MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:GUNDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-735-9192
Mailing Address - Street 1:7582 CURRELL BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2262
Mailing Address - Country:US
Mailing Address - Phone:651-735-9192
Mailing Address - Fax:651-735-0011
Practice Address - Street 1:10995 CLUB WEST PKWY
Practice Address - Street 2:SUITE 500
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-5058
Practice Address - Country:US
Practice Address - Phone:763-230-7880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-17
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4225850001Medicare PIN