Provider Demographics
NPI:1629890082
Name:SUPERIOR MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:SUPERIOR MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KASIB
Authorized Official - Middle Name:
Authorized Official - Last Name:MATEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-593-1492
Mailing Address - Street 1:1010 N TENNESSEE ST STE 216
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-8528
Mailing Address - Country:US
Mailing Address - Phone:470-327-9292
Mailing Address - Fax:470-274-3238
Practice Address - Street 1:1010 N TENNESSEE ST STE 216
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-8528
Practice Address - Country:US
Practice Address - Phone:470-327-9292
Practice Address - Fax:470-274-3238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies