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General NPI Number Information
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NPI Number | 1659655413
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Entity Type | Organization
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Legal Business Name | SENIOR SMART, LLC
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1430 PROGRESS WAY STE 105
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City | ELDERSBURG
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State | MD
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Zip | 21784-6461
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Country | US
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Telephone | 410-259-6622
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Fax | 443-973-1012
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Provider Business Mailing Address
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Address Line | 1430 PROGRESS WAY STE 105
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City | ELDERSBURG
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State | MD
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Zip | 21784-6461
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Country | US
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Telephone | 410-259-6622
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Fax | 443-973-1012
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL MACK
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Credential | OTR
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Telephone | 410-259-6622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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