MEDICARE: MEDICAL SUPER CENTER

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	:	1124335013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL SUPER CENTER

Provider Business Mailing Address
First Line	:	5246 S 40TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-9009
Country	:	US
Telephone Number	:	602-470-9700
Fax Number	:	602-454-6306

Provider Business Practice Location Address
First Line	:	10001 W BELL RD
Second Line	:	104
City	:	SUN CITY
State	:	AZ
Zip	:	85351-1282
Country	:	US
Telephone Number	:	623-209-2922
Fax Number	:	623-209-2924

Authorized Official
Title or Position	:	VP
Name	:	KAREN MARTIN
Credential	:
Telephone Number	:	602-470-9700

Provider Enumeration Date	:	09/13/2010
Last Update Date	:	09/14/2010

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Directions to “MEDICAL SUPER CENTER ” Practice Location

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