Provider Demographics
NPI:1316318165
Name:SENIOR MEDICAL SUPPLIES, INC.
Entity type:Organization
Organization Name:SENIOR MEDICAL SUPPLIES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CARVAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-936-3360
Mailing Address - Street 1:2751 ENTERPRISE RD
Mailing Address - Street 2:STE 113
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8256
Mailing Address - Country:US
Mailing Address - Phone:888-536-7516
Mailing Address - Fax:888-536-7517
Practice Address - Street 1:2751 ENTERPRISE RD
Practice Address - Street 2:STE 113
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8256
Practice Address - Country:US
Practice Address - Phone:888-536-7516
Practice Address - Fax:888-536-7517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies