MEDICARE: SUPERIOR NURSING SOLUTIONS

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	251E00000X	Home Health Agency
2	163WH0200X	Home Health Registered Nurse		SC

General Provider Information

NPI Number	:	1952810434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPERIOR NURSING SOLUTIONS

Provider Business Mailing Address
First Line	:	1315 W MARTINTOWN RD STE A-5
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29860-7631
Country	:	US
Telephone Number	:	803-279-2770
Fax Number	:	803-279-2770

Provider Business Practice Location Address
First Line	:	1315 W MARTINTOWN RD STE A-5
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29860-7631
Country	:	US
Telephone Number	:	803-279-2770
Fax Number	:	803-279-2770

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ALLEN MICHAEL DUNN
Credential	:
Telephone Number	:	706-831-9513

Provider Enumeration Date	:	09/27/2017
Last Update Date	:	05/06/2020

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