NPIMap

Organization Active NPI

Superior Source Inc

  • Contractor
  • Little Rock, AR
National Provider Identifier
1689883209
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Legal business name
SUPERIOR SOURCE INC
Practice address
78 Westminister Dr
Little Rock, AR 72209-2949
Phone
(501) 568-4785
Fax
(501) 562-0603
NPI assigned
May 21, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Vernon Olandus Jordan
Title
President
Phone
(501) 568-4785

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Primary

Addresses

Primary practice location

78 Westminister Dr
Little Rock, AR 72209-2949

Mailing address

78 Westminister Dr
Little Rock, AR 72209-2949
Phone (501) 568-4785

National Provider Directory

National Provider Directory

Locations

78 Westminister Dr
Little Rock, AR 72209
Phone (501) 568-4785

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689883209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 WESTMINISTER DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722092949",
            "telephone_number": "501-568-4785",
            "fax_number": "501-562-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 WESTMINISTER DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722092949",
            "telephone_number": "501-568-4785",
            "fax_number": "501-562-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR SOURCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "VERNON",
        "authorized_official_middle_name": "OLANDUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-568-4785",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.