Provider Demographics
NPI:1750170494
Name:SUPERIOR SURGICAL
Entity type:Organization
Organization Name:SUPERIOR SURGICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:INDELICATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-907-3929
Mailing Address - Street 1:402 CARR ST
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1615
Mailing Address - Country:US
Mailing Address - Phone:267-907-3929
Mailing Address - Fax:800-770-3224
Practice Address - Street 1:402 CARR ST
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1615
Practice Address - Country:US
Practice Address - Phone:267-907-3929
Practice Address - Fax:800-770-3224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies