Active NPI
Senior Medical Supplies LLC
- Durable Medical Equipment & Medical Supplies
- Brooklyn, NY
National Provider Identifier
1881370997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- SENIOR MEDICAL SUPPLIES LLC
- Practice address
- 1109 Avenue S
Brooklyn, NY 11223-3346 - Phone
- (929) 778-1414
- Fax
- (929) 335-2511
- NPI assigned
- Jun 23, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anvarjon Gulomov
- Title
- President
- Phone
- (707) 460-5959
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
1109 Avenue S
Brooklyn, NY 11223-3346
Mailing address
1109 Avenue S
Brooklyn, NY 11223-3346
Phone (929) 778-1414
National Provider Directory
National Provider DirectoryLocations
11829 N 19th Ave
Phoenix, AZ 85029
Phone (602) 368-4617
1109 Avenue S
Brooklyn, NY 11223
Phone (929) 778-1414
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687478400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761523200000",
"number": "1881370997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1109 AVENUE S",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112233346",
"telephone_number": "929-778-1414",
"fax_number": "929-335-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1109 AVENUE S",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112233346",
"telephone_number": "929-778-1414",
"fax_number": "929-335-2511"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENIOR MEDICAL SUPPLIES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-06-23",
"last_updated": "2025-10-27",
"certification_date": "2025-10-27",
"status": "A",
"authorized_official_last_name": "GULOMOV",
"authorized_official_first_name": "ANVARJON",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "707-460-5959"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.