MEDICARE: SUPERIOR MEDICAL EQUIPMENT AND SUPPLIES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0F31746	OTHER	MI	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1831238302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPERIOR MEDICAL EQUIPMENT AND SUPPLIES INC

Provider Business Mailing Address
First Line	:	56187 NICKELBY S
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48316-5502
Country	:	US
Telephone Number	:	248-542-7440
Fax Number	:	248-545-4327

Provider Business Practice Location Address
First Line	:	27031 DEQUINDRE RD
Second Line	:
City	:	MADISON HTS
State	:	MI
Zip	:	48071-3401
Country	:	US
Telephone Number	:	248-542-7440
Fax Number	:	248-545-4327

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MARIA MAHMOOD
Credential	:
Telephone Number	:	248-542-7440

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	08/22/2020

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