Provider Demographics
NPI:1033164694
Name:COMPLETE MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:COMPLETE MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VADIM
Authorized Official - Middle Name:
Authorized Official - Last Name:POVZLOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-932-8374
Mailing Address - Street 1:PO BOX 230181
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-0181
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7303 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5636
Practice Address - Country:US
Practice Address - Phone:646-932-8374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies