Provider Demographics
NPI:1184736530
Name:SENIOR MEDICAL PRODUCTS INC
Entity type:Organization
Organization Name:SENIOR MEDICAL PRODUCTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMBARDZUMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-989-5551
Mailing Address - Street 1:14126 SHERMAN WAY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-5600
Mailing Address - Country:US
Mailing Address - Phone:818-989-5551
Mailing Address - Fax:
Practice Address - Street 1:14126 SHERMAN WAY
Practice Address - Street 2:SUITE 5
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-5600
Practice Address - Country:US
Practice Address - Phone:818-989-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5545410001Medicare NSC