Provider Demographics
NPI:1720319965
Name:SUPERIOR PAIN THERAPY EQUIPMENT LLC
Entity Type:Organization
Organization Name:SUPERIOR PAIN THERAPY EQUIPMENT LLC
Other - Org Name:SUPERIOR PAIN THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-688-2367
Mailing Address - Street 1:25400 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 136
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-2149
Mailing Address - Country:US
Mailing Address - Phone:727-451-7872
Mailing Address - Fax:727-451-7874
Practice Address - Street 1:25400 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 136
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-2149
Practice Address - Country:US
Practice Address - Phone:727-451-7872
Practice Address - Fax:727-451-7874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies