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General NPI Number Information
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NPI Number | 1659801488
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Entity Type | Organization
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Legal Business Name | SUPERIOR HOME MEDICAL, INC
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 06/28/2017
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Provider Practice Location Address
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Address Line | 201 N MAIN ST STE 110
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City | MONROE
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State | NC
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Zip | 28112-4753
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Country | US
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Telephone | 980-269-8382
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Fax | 980-269-8383
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Provider Business Mailing Address
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Address Line | 108 S MAIN ST
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City | MONROE
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State | NC
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Zip | 28112-5541
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Country | US
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Telephone | 704-225-0285
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Fax | 704-225-0287
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. COURTNEY STEVENS GARRISON
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Credential | C.PED, CFM
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Telephone | 704-225-0285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224900000X
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Taxonomy Name | Mastectomy Fitter
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License Number | CFM02947
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License Number State | NC
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