SENIOR CITIZENS MEDICAL SUPPLY
NPI 1659330223
Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition in Henderson, NC


Overall Rating: 1 out of 5 stars

NPI Status: Active since March 21, 2006

Contact Information

578 ROWLAND ST
HENDERSON, NC
ZIP 27536
Phone: (252) 492-3842

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  • Organization
  • Durable Medical Equipment & Medical Supp...
  • Parenteral & Enteral Nutrition
  • CLIA Number: 34D0239996
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 08-31-2026

About SENIOR CITIZENS MEDICAL SUPPLY

This page provides the complete NPI Profile along with additional information for Senior Citizens Medical Supply, a provider established in Henderson, North Carolina operating as a Durable Medical Equipment & Medical Supplies, focusing in parenteral & enteral nutrition . The healthcare provider is registered in the NPI registry with number 1659330223 assigned on March 2006. The practitioner's primary taxonomy code is 332BP3500X with license number 335 (NC). The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mr. Herman A. Davis Iii (Administrator)

NPI
1659330223
Provider Name
SENIOR CITIZENS MEDICAL SUPPLY
Entity Type
Organization
Location Address
578 ROWLAND ST HENDERSON, NC 27536
Location Phone
(252) 492-3842
Mailing Address
578 ROWLAND ST HENDERSON, NC 27536
Mailing Phone
(252) 492-3842
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-21-2006
Last Update Date
09-11-2025
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According to the Nursing Home Compare program data, Senior Citizens Medical Supply has a much below average overall quality rating based on the provider's performance on three separate measures including: health inspections, staffing, and quality of resident care information. These quality measures, combined in a star rating of 1 out of 5 stars provide a snapshot of this nursing home quality.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition

Taxonomy Code
332BP3500X
Type
Suppliers
License No.
335
License State
NC

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1332B00000XSuppliers

Durable Medical Equipment & Medical Supplies

335 (NC)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. HERMAN A. DAVIS III

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(252) 492-3842

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
7700397MEDICAID (05)NC 
0490KOTHER (01)NCBLUE CROSS BLUE SHIELD

Nursing Home Quality Information

The Centers for Medicare and Medicaid Services publishes the Nursing Home Compare star rating data to provide consumers an easy way to compare nursing home's quality of care.

Overall Quality Rating - 1 out of 5 stars - Much Below Average
The overall star rating is based on a nursing homes's performance on health inspections, staffing and quality measures.
Health Inspection RatingNot Available
The health inspection star rating is based on a nursing home’s weighted score from the most recent health inspections.
Quality Measures Rating - 3 out of 5 stars - Average
The quality measures star rating is based on data from a select set of clinical measures.
Long-Stay Quality Measures Rating - 2 out of 5 stars - Below Average
The long-stay quality of care rating is based on the quality of care delivered to long-term residents only.
Short-Stay Quality Measures Rating - 4 out of 5 stars - Above Average
The short-stay quality of care rating is based on the quality of care delivered to temporary residents only.
Staffing Rating - 1 out of 5 stars - Much Below Average
The staffing rating is based on the star rating based on the nursing home’s staffing hours for Registered Nurses (RNs), Licensed Practice Nurses (LPNs), Licensed Vocational Nurses (LVNs) and Nurse aides.
*This facility either did not submit staffing data, has reported a high number of days without a registered nurse onsite, or submitted data that could not be verified through an audit.
Nurse Aide Staffing Hours3.3 hours per resident per day
Nurse aide hours per resident per day. Higher number of hours are better.
RN Staffing Hours0.23 hours per resident per day
Resgistered nurse hours per resident per day. Higher number of hours are better.
RN Staff Turnover100%
Resgistered nurse turnover is the percentage of registered nursing staff who stop working at the facility within a given year.
Administrator Turnover1
Number of administrators who left the nursing home within a given year.
Ownership TypeFor profit - Limited Liability company
Is the facility private for profit, not-for profit or publicly owned.
Number of Certified Beds60 beds
Number of beds in the nursing home that have been approved by the federal government to participate in the Medicare or Medicaid programs.
Residents per Day47 residents
Average number of residents living in the facility per day.
Automatic Sprinkler SystemsYes
Does the facility have automatic sprinkler systems in all required areas?
Facility Reported Incidents1 incidents
Number of facility-reported incidents in the past 3 years. A lower number is better.
Substantiated Complaints7 complaints
Number of substantiated complaints in the past 3 years. A lower number is better.
Citations from Inspections citations after infection control inspection
Number of citations from infection control inspections in the past 3 years. A lower number is better.
Total Number of Penalties2 penalties from a serious health, fire safety or long-term unresolved citation
The Medicare program may impose penalties on a facilty when there's serious health or fire safety citations or if the facility fails to correct a citation for a long period of time.
Number of Fines1 fines
Toal number of fines in the last 3 years. A penalty can be a fine against the facility or denied payments from Medicare.
Amount of Fines$55760.25
Total monetary amount of fine imposed on the facility in the last 3 years.

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
34D0239996
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
LEAH PERNELL RN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Senior Citizens Medical Supply to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1659330223, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
9
Unchanged
Pos 5
3
Doubled → 6
Pos 6
3
Unchanged
Pos 7
0
Doubled → 0
Pos 8
2
Unchanged
Pos 9
2
Doubled → 4
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 3 → 6 0 → 0 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 0 + 9 + 6 + 3 + 0 + 2 + 4 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1659330223.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1659330223, enumerated as an "organization" on March 21, 2006.

The provider is located at 578 ROWLAND ST HENDERSON, NC 27536 and the phone number is (252) 492-3842.

Durable Medical Equipment & Medical Supplies with taxonomy code 332BP3500X and a focus in Parenteral & Enteral Nutrition.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.