Provider Demographics
NPI:1124536644
Name:SUPERIOR WAY INC
Entity type:Organization
Organization Name:SUPERIOR WAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANATOLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHVARTSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-706-8133
Mailing Address - Street 1:375 DICK RD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1816
Mailing Address - Country:US
Mailing Address - Phone:716-391-1925
Mailing Address - Fax:716-391-1924
Practice Address - Street 1:375 DICK RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-1816
Practice Address - Country:US
Practice Address - Phone:716-391-1925
Practice Address - Fax:716-391-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04554032343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04554032Medicaid