MEDICARE: SENIOR MEDICAL EQUIPMENT

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	:	1942270715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR MEDICAL EQUIPMENT

Provider Business Mailing Address
First Line	:	708 W 15TH ST
Second Line	:	SUITE 120
City	:	EDMOND
State	:	OK
Zip	:	73013-3750
Country	:	US
Telephone Number	:	405-715-0300
Fax Number	:	405-715-0319

Provider Business Practice Location Address
First Line	:	708 W 15TH ST
Second Line	:	SUITE 120
City	:	EDMOND
State	:	OK
Zip	:	73013-3652
Country	:	US
Telephone Number	:	405-715-0300
Fax Number	:	405-715-0319

Authorized Official
Title or Position	:	OWNER
Name	:	KANE SHERMAN
Credential	:
Telephone Number	:	405-715-0300

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	08/22/2020

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