Healthcare Provider Details

I. General information

NPI: 1518964618
Provider Name (Legal Business Name): SUPERIOR HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 MAIN ST
DUPONT PA
18641-2014
US

IV. Provider business mailing address

224 MAIN ST
DUPONT PA
18641-2014
US

V. Phone/Fax

Practice location:
  • Phone: 570-883-9581
  • Fax: 570-883-7001
Mailing address:
  • Phone: 570-883-9581
  • Fax: 570-883-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number752105
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01272785
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier1J
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CROSS
# 3
Identifier806265
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerFIRST PRIORITY

VIII. Authorized Official

Name: MRS. ANGELA SALITIS
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 570-883-9581