Provider Demographics
NPI:1164279980
Name:SUPER HEALTH LLC
Entity type:Organization
Organization Name:SUPER HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUDHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:339-224-7461
Mailing Address - Street 1:1436 CALIFORNIA CIR
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-3022
Mailing Address - Country:US
Mailing Address - Phone:339-224-7461
Mailing Address - Fax:
Practice Address - Street 1:2834 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-4002
Practice Address - Country:US
Practice Address - Phone:339-224-7461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health