# DELUXE MEDICAL SUPPLY LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DELUXE MEDICAL SUPPLY LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003620683
- **Legal business name:** DELUXE MEDICAL SUPPLY LLC
- **Authorized official:** ALINA TYMOSHENKO (RIVERSIDE BRANCH MANAGER)
- **Authorized official phone:** (949) 820-5454

## Contact information

- **Practice address:** 4240 LATHAM ST STE E, RIVERSIDE, CA 92501-1741
- **Practice address phone:** (951) 344-3777
- **Practice address fax:** (951) 344-3773
- **Mailing address:** 7474 EL CAJON BLVD, LA MESA, CA 91942-7420
- **Mailing address phone:** (619) 741-5901
- **Mailing address fax:** (619) 741-5910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 02/04/2025
- **Last updated:** 09/17/2026