Provider Demographics
NPI:1962805887
Name:SUPERIOR HEALTHCARE PHYSICAL MEDICINE OF NORTH HILLS PC
Entity type:Organization
Organization Name:SUPERIOR HEALTHCARE PHYSICAL MEDICINE OF NORTH HILLS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEDGES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-401-1999
Mailing Address - Street 1:3900 BARRETT DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6641
Mailing Address - Country:US
Mailing Address - Phone:919-401-1999
Mailing Address - Fax:
Practice Address - Street 1:3900 BARRETT DR
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6641
Practice Address - Country:US
Practice Address - Phone:919-401-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty