# SUPER SHOT INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427373372
- **Authorized official:** CONNIE HEFLIN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (260) 424-7468

## Contact information

- **Practice address:** 1515 HOBSON RD, FORT WAYNE, IN 46805-4802
- **Practice address phone:** (260) 424-7468
- **Practice address fax:** (260) 739-5623
- **Mailing address:** 1515 HOBSON RD, FORT WAYNE, IN 46805-4802
- **Mailing address phone:** (260) 424-7468
- **Mailing address fax:** (260) 739-5623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | N/A | IN | Yes |

## Other

- **Enumeration date:** 04/05/2010
- **Last updated:** 05/08/2024