Provider Demographics
NPI:1073815536
Name:SENIOR CARE MEDICAL, INC.
Entity Type:Organization
Organization Name:SENIOR CARE MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:NICKOLOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-267-8800
Mailing Address - Street 1:1500 W CYPRESS CREEK RD
Mailing Address - Street 2:STE. 412
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1833
Mailing Address - Country:US
Mailing Address - Phone:954-267-8800
Mailing Address - Fax:
Practice Address - Street 1:1500 W CYPRESS CREEK RD
Practice Address - Street 2:STE. 412
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1833
Practice Address - Country:US
Practice Address - Phone:954-267-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-03
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies