MEDICARE: SENIOR MEDICAL SUPPLIES, INC

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	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1669578084
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR MEDICAL SUPPLIES, INC

Provider Business Mailing Address
First Line	:	1967 LONGWOOD LAKE MARY RD STE 1007
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-4673
Country	:	US
Telephone Number	:	888-536-7516
Fax Number	:	888-536-7517

Provider Business Practice Location Address
First Line	:	1967 LONGWOOD LAKE MARY RD STE 1007
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-4673
Country	:	US
Telephone Number	:	888-536-7516
Fax Number	:	888-536-7517

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BRADLEY N THOMAS
Credential	:
Telephone Number	:	888-536-7516

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	02/08/2016

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