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General NPI Number Information
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NPI Number | 1447281191
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Entity Type | Organization
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Legal Business Name | SUPERIOR, INC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 42382 BOB HOPE DR
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-4469
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Country | US
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Telephone | 760-341-9619
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Fax | 760-776-5861
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Provider Business Mailing Address
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Address Line | 42382 BOB HOPE DR
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-4469
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Country | US
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Telephone | 760-341-9619
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Fax | 760-776-5861
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH ANTHONY MANHART
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Credential | BC/HIS
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Telephone | 760-341-9619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | HA3138
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License Number State | CA
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