MEDICARE: SENIOR CARE MEDICAL, 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

General Provider Information

NPI Number	:	1073815536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR CARE MEDICAL, INC.

Provider Business Mailing Address
First Line	:	1500 W CYPRESS CREEK RD
Second Line	:	STE. 412
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-1833
Country	:	US
Telephone Number	:	954-267-8800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 W CYPRESS CREEK RD
Second Line	:	STE. 412
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-1833
Country	:	US
Telephone Number	:	954-267-8800
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. AMY NICKOLOPOULOS
Credential	:
Telephone Number	:	954-267-8800

Provider Enumeration Date	:	12/03/2010
Last Update Date	:	12/27/2010

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