Up Superior Enterprises Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

00194T Issued in MI

Legal business name

UP SUPERIOR ENTERPRISES INC

Practice address

2303 Ashmun St
Sault Sainte Marie, MI 49783-3749

Phone

(906) 632-3772

Fax

(906) 632-0309

NPI assigned

May 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ronald Anthony Gordon

Title

Owner

Phone

(906) 632-6736

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Tax ID family

Up Superior Enterprises Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Up Superior Enterprises, Inc

  • Oxygen Equipment & Supplies (DME)
  • Newberry, MI
  • NPI 1063657286
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520294400000",
    "number": "1275740318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 ASHMUN ST",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497833711",
            "telephone_number": "906-632-3772",
            "fax_number": "906-632-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 ASHMUN ST",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497833749",
            "telephone_number": "906-632-3772",
            "fax_number": "906-632-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UP SUPERIOR ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2018-03-06",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "906-632-6736",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "MI",
            "license": "00194T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275740318",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "540A70445",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alec Joseph Tuchowski, AGPCNP-BC
• Courtney Tyner
• U.P. Stress Center Psychological Solutions
• U.P. Superior Smiles
• Laura Kay Ullery, DPT
• Bryan Upham, PT, DPT
• Mohammed Tariq Vakani, M.D.
• Malaisha Van
• Lindsey Vansloten, COTA/L
• Abby M Vansumeren

• Oxygen Equipment & Supplies (DME) in Sault Sainte Marie, MI
• Providers in Sault Sainte Marie, MI by specialty
• Oxygen Equipment & Supplies (DME) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.