| Organization Name: | SUPERSALE CORPORATION |
| NPI Number: | 1235541087 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KATIE SIPE (REGISTED DIETITIAN) |
| Mailing Address: | 20111 Route 19 Cranberry Township |
| State: | PA US |
| Postal Code: | 160666207 |
| Phone Number: | 7247721030 |
| Fax Number: | 7247722841 |
| NPI Enumeration Date: | 05/28/2014 |
| NPI Last Update Date: | 05/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | DN004225 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |