Avicenna Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

AVICENNA MEDICAL SUPPLY

Practice address

4045 Wadsworth Blvd
Unit # 308
Wheat Ridge, CO 80033-4642

Phone

(303) 388-7114

NPI assigned

Oct 27, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rostislav Vaisman

Title

President

Phone

(303) 388-7114

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1275869158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 WADSWORTH BLVD",
            "address_2": "UNIT # 308",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334642",
            "telephone_number": "303-388-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 WADSWORTH BLVD",
            "address_2": "UNIT # 308",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334642",
            "telephone_number": "303-388-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVICENNA MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "VAISMAN",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-388-7114"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cathy Austin
• Samantha Austin
• Autism Forensics
• Sarah M Auvil
• Avicenna Acupuncture LLC (Avicenna Acupuncture and Lymphedema Care)
• Avid Physical Therapy
• Alla Ayers
• Cara Ayon
• Baby and Co LLC (Baby and Company Wheatridge LLC)
• Back to Motion Physical Therapy (RoMoRA)

• Durable Medical Equipment & Medical Supplies in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Durable Medical Equipment & Medical Supplies in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.