MEDICARE: UPWARD MEDICAL EQUIPMENT SUPPLY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1023765179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPWARD MEDICAL EQUIPMENT SUPPLY

Provider Business Mailing Address
First Line	:	3216 W PARK ROW DR STE A
Second Line	:
City	:	PANTEGO
State	:	TX
Zip	:	76013-3136
Country	:	US
Telephone Number	:	817-466-0920
Fax Number	:	817-466-1270

Provider Business Practice Location Address
First Line	:	3216 W PARK ROW DR STE A
Second Line	:
City	:	PANTEGO
State	:	TX
Zip	:	76013-3136
Country	:	US
Telephone Number	:	817-466-0920
Fax Number	:	817-466-1270

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. GBADEBO AKINLUA
Credential	:
Telephone Number	:	470-403-7856

Provider Enumeration Date	:	03/08/2022
Last Update Date	:	05/17/2022

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Directions to “UPWARD MEDICAL EQUIPMENT SUPPLY ” Practice Location

Language	Start Address	Practice Location

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