Senior Citizens Medical Supply

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

License

335 Issued in NC

Legal business name

SENIOR CITIZENS MEDICAL SUPPLY

Practice address

578 Rowland St
Henderson, NC 27536-4358

Phone

(252) 492-3842

NPI assigned

Mar 21, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Herman A. Davis III

Title

Administrator

Phone

(252) 492-3842

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1659330223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 ROWLAND ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364358",
            "telephone_number": "252-492-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 ROWLAND ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364358",
            "telephone_number": "252-492-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR CITIZENS MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "HERMAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "252-492-3842",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "335",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NC",
            "license": "335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700397",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0490K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Henderson, NC by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.