Organization
SENIOR CITIZENS MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERMAN A. DAVIS III (ADMINISTRATOR)
(252) 492-3842
Entity
Organization
Contact information
Practice address
578 ROWLAND ST, HENDERSON, NC 27536-4358
(252) 492-3842
Mailing address
578 ROWLAND ST, HENDERSON, NC 27536-4358
(252) 492-3842
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
335
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
335
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0490K
BLUE CROSS BLUE SHIELD
NC
05
—
7700397
—
NC
Enumeration date
03/21/2006
Last updated
09/11/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up