# VICWEST MEDICAL EQUIPMENT & SUPPLY INC

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

## Provider details

- **NPI number:** 1740594506
- **Authorized official:** MR. RUSLAN TEMIREZOV (CEO/PRESIDENT)
- **Authorized official phone:** (323) 462-4070

## Contact information

- **Practice address:** 5347 SANTA MONICA BLVD, LOS ANGELES, CA 90029-1105
- **Practice address phone:** (323) 462-4070
- **Practice address fax:** (323) 462-4270
- **Mailing address:** 5347 SANTA MONICA BLVD, LOS ANGELES, CA 90029-1105
- **Mailing address phone:** (323) 462-4070
- **Mailing address fax:** (323) 462-4270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 000251095100018 | CA | Yes |

## Other

- **Enumeration date:** 08/03/2010
- **Last updated:** 11/21/2011