MEDICARE: SMRT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332B00000X	Durable Medical Equipment & Medical Supplies	103041	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124104146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMRT LLC

Provider Business Mailing Address
First Line	:	5330 CARROLL CANYON RD STE 120
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3758
Country	:	US
Telephone Number	:	858-755-7285
Fax Number	:	858-755-7243

Provider Business Practice Location Address
First Line	:	5330 CARROLL CANYON RD STE 120
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3758
Country	:	US
Telephone Number	:	858-755-7285
Fax Number	:	858-755-7243

Authorized Official
Title or Position	:	OWNER
Name	:	MR. NEIL MCKAY
Credential	:	DME
Telephone Number	:	858-755-7285

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	07/10/2020

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Directions to “SMRT LLC ” Practice Location

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