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
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