NPI 1427373372

Super Shot INC.

Organisation Public Health or Welfare Agency Fort Wayne, IN

Practice location

Address: 1515 Hobson Rd, Fort Wayne, IN 46805-4802
Phone: (260) 424-7468
Fax: (260) 739-5623

Authorised official

Name: Connie Heflin
Title: Executive Director
Phone: (260) 424-7468

Registered specialties

Public Health or Welfare Agency Primary

Agencies Taxonomy 251K00000X Licence N/A (IN)

Other Public Health or Welfare providers in Indiana →

Registry record

NPI: 1427373372
Entity type: Organization
NPI issued: 5 Apr 2010
Record last updated: 8 May 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.