Organization Active NPI

Vine Medical Supplies

  • Durable Medical Equipment & Medical Supplies
  • West Hollywood, CA
National Provider Identifier
1649314741
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
332B00000X Issued in CA
Legal business name
VINE MEDICAL SUPPLIES
Practice address
7406 Santa Monica Blvd
West Hollywood, CA 90046-5605
Phone
(323) 469-2255
Fax
(323) 469-7697
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Authorized official

Name
Ms. Anait AdzhemyanNPI 1558520536
Title
Owner
Phone
(323) 469-2255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 332B00000X CA Primary

Addresses

Primary practice location

7406 Santa Monica Blvd
West Hollywood, CA 90046-5605

Mailing address

7406 Santa Monica Blvd
West Hollywood, CA 90046-5605
Phone (323) 469-2255

Other identifiers 1

IdentifierTypeStateIssuer
DME02820FMedicaidCA

National Provider Directory

National Provider Directory

Locations

7406 Santa Monica Blvd
West Hollywood, CA 90046
Phone (323) 469-2255

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1649314741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7406 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465605",
            "telephone_number": "323-469-2255",
            "fax_number": "323-469-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7406 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465605",
            "telephone_number": "323-469-2255",
            "fax_number": "323-469-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINE MEDICAL SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "ADZHEMYAN",
        "authorized_official_first_name": "ANAIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-469-2255",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "332B00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME02820F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; 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.