Organization
SENIORS MEDICAL SUPPLY
Active
Other names
Seniors Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VANESSA T. COBLE PHD (PRESIDENT / OWNER)
(336) 227-0730
Entity
Organization
Contact information
Practice address
540 W ELM ST, GRAHAM, NC 27253-2158
(236) 227-0730
(336) 227-0732
Mailing address
540 WEST ELM STREET, GRAHAM, NC 27253-2158
(236) 227-0730
(336) 227-0732
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010186889
—
VA
01
—
046TK
BCBS OF NC
NC
05
—
7704282
—
NC
Enumeration date
12/19/2005
Last updated
01/30/2012
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