# VINE MEDICAL SUPPLIES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649314741
- **Authorized official:** MS. ANAIT ADZHEMYAN (OWNER)
- **Authorized official phone:** (323) 469-2255

## Contact information

- **Practice address:** 7406 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90046-5605
- **Practice address phone:** (323) 469-2255
- **Practice address fax:** (323) 469-7697
- **Mailing address:** 7406 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90046-5605
- **Mailing address phone:** (323) 469-2255
- **Mailing address fax:** (323) 469-7697

## Taxonomy

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

## Other

- **Enumeration date:** 02/20/2007
- **Last updated:** 02/04/2008