Provider Demographics
NPI:1528436607
Name:SUPERIOR MOBILITY LLC
Entity type:Organization
Organization Name:SUPERIOR MOBILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-430-8986
Mailing Address - Street 1:21 N CASS AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:56087-1501
Mailing Address - Country:US
Mailing Address - Phone:507-920-7864
Mailing Address - Fax:507-723-5017
Practice Address - Street 1:21 N CASS AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MN
Practice Address - Zip Code:56087-1501
Practice Address - Country:US
Practice Address - Phone:507-920-7864
Practice Address - Fax:507-723-5017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN381422343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA908178200Medicaid