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General NPI Number Information
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NPI Number | 1073750949
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Entity Type | Organization
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Legal Business Name | SUPERIOR MED SURGICAL, INC.
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 06/01/2010
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Provider Practice Location Address
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Address Line | 9445 FAIRWAY VIEW PL. #100
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730
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Country | US
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Telephone | 909-980-0065
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Fax | 909-980-0303
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Provider Business Mailing Address
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Address Line | 1030 N MOUNTAIN AVE #201
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City | ONTARIO
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State | CA
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Zip | 91762
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Country | US
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Telephone | 909-980-0065
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Fax | 909-980-0303
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Authorized Official
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Title or Position | OPERATION MANAGER
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Name | CARMELITA S. AMORANTO
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Credential |
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Telephone | 909-980-0065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | N/A
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | HMDR LICENSE # 51915
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License Number State | CA
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