MEDICARE: SUPERIOR MEDICAL SUPPLIES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1083720189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPERIOR MEDICAL SUPPLIES INC

Provider Business Mailing Address
First Line	:	1581 BLOOMINGDALE RD
Second Line	:	SUITE B
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-2750
Country	:	US
Telephone Number	:	630-868-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1581 BLOOMINGDALE RD
Second Line	:	SUITE B
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-2750
Country	:	US
Telephone Number	:	630-868-3900
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KASHIF BUTT
Credential	:
Telephone Number	:	630-868-3900

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	02/26/2009

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