Provider Demographics
NPI:1023765179
Name:UPWARD MEDICAL EQUIPMENT SUPPLY
Entity type:Organization
Organization Name:UPWARD MEDICAL EQUIPMENT SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GBADEBO
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINLUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-403-7856
Mailing Address - Street 1:3216 W PARK ROW DR STE A
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-3136
Mailing Address - Country:US
Mailing Address - Phone:817-466-0920
Mailing Address - Fax:817-466-1270
Practice Address - Street 1:3216 W PARK ROW DR STE A
Practice Address - Street 2:
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-3136
Practice Address - Country:US
Practice Address - Phone:817-466-0920
Practice Address - Fax:817-466-1270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies