Organization
SENIORS MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANESSA COBLE PH.D. (PRESIDENT)
(336) 227-0730
Entity
Organization
Contact information
Practice address
124 W CRESCENT SQUARE DR, GRAHAM, NC 27253-4014
(336) 227-0730
(336) 227-0732
Mailing address
540 W ELM ST, GRAHAM, NC 27253-2158
(336) 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
05
—
7704282
—
NC
05
—
7795360
—
NC
05
—
DE2653
—
SC
Enumeration date
04/29/2013
Last updated
07/30/2021
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