Avicenna Medical Supply
NPI #1275869158 in Wheat Ridge, Colorado
Provider Information
- NPI Number
- 1275869158
- Entity Type
- Organization
- Organization Name
- Avicenna Medical Supply
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Oct 27, 2009
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 4045 WADSWORTH BLVD
- Address 2
- UNIT # 308
- City
- Wheat Ridge
- State
- Colorado
- ZIP Code
- 80033-4642
- Phone
- (303) 388-7114
Authorized Official
- Name
- ROSTISLAV VAISMAN
- Title
- PRESIDENT
- Phone
- (303) 388-7114
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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