Provider Demographics
NPI:1457973521
Name:SENIOR MEDICAL AIDS & PHARMACY LLC
Entity Type:Organization
Organization Name:SENIOR MEDICAL AIDS & PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:DIMEMMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-392-6416
Mailing Address - Street 1:344 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-4710
Mailing Address - Country:US
Mailing Address - Phone:951-392-6416
Mailing Address - Fax:
Practice Address - Street 1:1357 N TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-5336
Practice Address - Country:US
Practice Address - Phone:951-392-6416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy