Provider Demographics
NPI:1679020267
Name:SERENA MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:SERENA MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:CERINA
Authorized Official - Last Name:CALLWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:340-244-2636
Mailing Address - Street 1:PO BOX 10281
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-3281
Mailing Address - Country:US
Mailing Address - Phone:340-244-2636
Mailing Address - Fax:
Practice Address - Street 1:3-4 ESTATE THOMAS
Practice Address - Street 2:4TH STREET
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-244-2636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies