Organization
VINE MEDICAL SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANAIT ADZHEMYAN (OWNER)
(323) 469-2255
Entity
Organization
Contact information
Practice address
7406 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90046-5605
(323) 469-2255
(323) 469-7697
Mailing address
7406 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90046-5605
(323) 469-2255
(323) 469-7697
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332B00000X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME02820F
—
CA
Enumeration date
02/20/2007
Last updated
02/04/2008
Update your record
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