Active NPI
NW Magnum LLC
- Durable Medical Equipment & Medical Supplies
- Kirkland, WA
National Provider Identifier
1174934707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- PANDING
- Legal business name
- NW MAGNUM LLC
- Practice address
- 108 Central Way
Kirkland, WA 98033-6106 - Phone
- (425) 576-0021
- NPI assigned
- May 16, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ruslan R Knyaz
- Title
- Ceo
- Phone
- (425) 576-0021
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | PANDING | Primary | |
| Prosthetic/Orthotic Supplier | 335E00000X | PANDING |
Addresses
Primary practice location
108 Central Way
Kirkland, WA 98033-6106
Mailing address
108 Central Way
Kirkland, WA 98033-6106
Phone (425) 576-0021
Other names 1
- Elite Medical Supply
National Provider Directory
National Provider DirectoryLocations
108 Central Way
Kirkland, WA 98033
Phone (425) 576-0021
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400198400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1400198400000",
"number": "1174934707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 CENTRAL WAY",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980336106",
"telephone_number": "425-576-0021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 CENTRAL WAY",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980336106",
"telephone_number": "425-576-0021"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NW MAGNUM LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-05-16",
"last_updated": "2014-05-16",
"status": "A",
"authorized_official_last_name": "KNYAZ",
"authorized_official_first_name": "RUSLAN",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "425-576-0021"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": "PANDING",
"primary": true
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": "PANDING",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Elite Medical Supply",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.