Provider Demographics
NPI:1306942925
Name:SUPERB NURSING & HEALTH CARE SERVICES INC
Entity type:Organization
Organization Name:SUPERB NURSING & HEALTH CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WADE
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:SR
Authorized Official - Credentials:ATTORNEY
Authorized Official - Phone:919-680-8600
Mailing Address - Street 1:PO BOX 884
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27702
Mailing Address - Country:US
Mailing Address - Phone:919-680-8600
Mailing Address - Fax:919-680-8601
Practice Address - Street 1:411 WEST CHAPEL HILL STREET
Practice Address - Street 2:SUITE 605
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701
Practice Address - Country:US
Practice Address - Phone:919-680-8600
Practice Address - Fax:919-680-8601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH C 1481251E00000X
NCH C 1308251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
7100179OtherPDN
6600379OtherPCS
3408617OtherCAP
7100293OtherPDN
6600531OtherPCS