Provider Demographics
NPI:1336929280
Name:VIP MED SUPPLY INC.
Entity Type:Organization
Organization Name:VIP MED SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AGARONOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-941-5559
Mailing Address - Street 1:254 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1205
Mailing Address - Country:US
Mailing Address - Phone:718-576-6033
Mailing Address - Fax:718-576-6034
Practice Address - Street 1:254 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1205
Practice Address - Country:US
Practice Address - Phone:718-576-6033
Practice Address - Fax:718-576-6034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies