Provider Demographics
NPI:1841067089
Name:HUPERNIKAO LLC
Entity type:Organization
Organization Name:HUPERNIKAO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHUN
Authorized Official - Middle Name:WOO
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-334-5082
Mailing Address - Street 1:9709 NORTHEAST PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-9706
Mailing Address - Country:US
Mailing Address - Phone:704-334-5082
Mailing Address - Fax:
Practice Address - Street 1:9709 NORTHEAST PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-9706
Practice Address - Country:US
Practice Address - Phone:704-334-5082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care