Provider Demographics
NPI:1043478985
Name:TOYE ELEWODE
Entity Type:Organization
Organization Name:TOYE ELEWODE
Other - Org Name:PEACELINK MEDICAL SUPPLY&EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOYE
Authorized Official - Middle Name:OLAREWAJU
Authorized Official - Last Name:ELEWODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-262-5500
Mailing Address - Street 1:2304 OAK LN
Mailing Address - Street 2:SUITE 1 & 2
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-8812
Mailing Address - Country:US
Mailing Address - Phone:972-262-5500
Mailing Address - Fax:972-767-3338
Practice Address - Street 1:2304 OAK LN
Practice Address - Street 2:SUITE 1 & 2
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-8812
Practice Address - Country:US
Practice Address - Phone:972-262-5500
Practice Address - Fax:972-767-3338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0103639332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6208520001Medicare NSC