Provider Demographics
NPI:1750162954
Name:SUPERB HEALTHCARE
Entity type:Organization
Organization Name:SUPERB HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:BETHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-303-1975
Mailing Address - Street 1:6704 KEYSTONE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-2436
Mailing Address - Country:US
Mailing Address - Phone:267-303-1975
Mailing Address - Fax:
Practice Address - Street 1:6704 KEYSTONE ST APT 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-2436
Practice Address - Country:US
Practice Address - Phone:267-303-1975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care