Super Shot Inc.

LBN: Super Shot Inc.
Super Shot Inc. is an health care organization with primary practice located at 1515 Hobson Rd , Fort Wayne IN 46805-4802. The organization recently has only one registered license in Agencies / Public Health or Welfare, which is considered as the primary health care specialty. Super Shot Inc. can be contacted via phone (260) 424-7468, or through Heflin, Connie via phone (260) 424-7468.

Contact Information

Primary practice address
1515 Hobson Rd Fort Wayne IN 46805-4802
Phone: (260) 424-7468
Fax: (260) 739-5623
Website:
Map and Directions
Authorized official contact:
Name: Heflin, Connie
Phone: (260) 424-7468

Health care specialties

SpecialtyCodeLicense #State
Agencies / Public Health or Welfare 251K00000X N/A Indiana

Profile Details

NPI number 1427373372
LBN Legal business name Super Shot Inc.
DBA Doing business as
Authorized official Heflin, Connie
Entity Organization
Organization subpart 1 No
Enumeration date Apr 5th, 2010
Last updated May 8th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427373372 NPPES
Indiana MEDICAID 200977620A

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