Provider Demographics
NPI:1326151077
Name:SENIORS MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:SENIORS MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:I
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-795-4697
Mailing Address - Street 1:PO BOX 50409
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-0409
Mailing Address - Country:US
Mailing Address - Phone:787-795-4697
Mailing Address - Fax:787-784-6895
Practice Address - Street 1:AVENIDA BLVD STE 1805
Practice Address - Street 2:URB LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-795-4697
Practice Address - Fax:787-784-6895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR54973OtherSEGUROS DE SERVICIOS DE S
PR54973OtherSEGUROS DE SERVICIOS DE S