Organization
DELUXE MEDICAL SUPPLY LLC
Active
Parent organization
DELUXE MEDICAL SUPPLY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DELUXE MEDICAL SUPPLY LLC
Authorized official
YERKEN TENIZBAYEV (MANAGING MEMBER)
(619) 741-5901
Entity
Organization
Contact information
Practice address
4240 LATHAM ST STE E, RIVERSIDE, CA 92501-1741
(619) 741-5901
(619) 741-5910
Mailing address
7474 EL CAJON BLVD, LA MESA, CA 91942-7420
(619) 741-5901
(619) 741-5910
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/04/2025
Last updated
07/09/2025
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