Healthcare Provider Details
I. General information
NPI: 1437075553
Provider Name (Legal Business Name): SUPER SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9740 CONANT ST
HAMTRAMCK MI
48212-3307
US
IV. Provider business mailing address
9740 CONANT ST
HAMTRAMCK MI
48212-3307
US
V. Phone/Fax
- Phone: 888-446-4118
- Fax: 888-804-0426
- Phone: 888-446-4118
- Fax: 888-804-0426
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHEN
VIBE
Title or Position: MANAGER
Credential:
Phone: 888-446-4118