Provider Demographics
NPI:1265172530
Name:SUPER ACUCARE, INC.
Entity type:Organization
Organization Name:SUPER ACUCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HONGDAR
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:CHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-510-8868
Mailing Address - Street 1:24 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3812
Mailing Address - Country:US
Mailing Address - Phone:609-510-8868
Mailing Address - Fax:
Practice Address - Street 1:646 ROUTE 18 STE 105A
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3722
Practice Address - Country:US
Practice Address - Phone:609-510-8868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty