MEDICARE: SUPERIOR VAN & MOBILITY

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	171WV0202X	Vehicle Modifications Contractor	128834	IN

General Provider Information

NPI Number	:	1306924733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPERIOR VAN & MOBILITY

Provider Business Mailing Address
First Line	:	1506 LAKE SHORE CT
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-3803
Country	:	US
Telephone Number	:	800-458-8267
Fax Number	:	866-457-8267

Provider Business Practice Location Address
First Line	:	5410 MADISON AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-4246
Country	:	US
Telephone Number	:	317-781-6900
Fax Number	:	866-859-8108

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	ERIN ENGELAU
Credential	:
Telephone Number	:	317-353-3818

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	02/03/2026

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Directions to “SUPERIOR VAN & MOBILITY ” Practice Location

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