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	:	1316318165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR MEDICAL SUPPLIES, INC.

Provider Business Mailing Address
First Line	:	2751 ENTERPRISE RD
Second Line	:	STE 113
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8256
Country	:	US
Telephone Number	:	888-536-7516
Fax Number	:	888-536-7517

Provider Business Practice Location Address
First Line	:	2751 ENTERPRISE RD
Second Line	:	STE 113
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8256
Country	:	US
Telephone Number	:	888-536-7516
Fax Number	:	888-536-7517

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MARIA C. CARVAJAL
Credential	:
Telephone Number	:	407-936-3360

Provider Enumeration Date	:	10/19/2015
Last Update Date	:	02/05/2016

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