Provider Demographics
NPI:1467634782
Name:OLALEKAM ADIGUM M SORUMKE
Entity Type:Organization
Organization Name:OLALEKAM ADIGUM M SORUMKE
Other - Org Name:LINCOLN MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLALEKAM
Authorized Official - Middle Name:ADIGUM
Authorized Official - Last Name:SORUMKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-553-2544
Mailing Address - Street 1:10935 ESTATE LN
Mailing Address - Street 2:SUITE 274
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2316
Mailing Address - Country:US
Mailing Address - Phone:214-553-2544
Mailing Address - Fax:214-503-0315
Practice Address - Street 1:10935 ESTATE LN
Practice Address - Street 2:SUITE 274
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2316
Practice Address - Country:US
Practice Address - Phone:214-553-2544
Practice Address - Fax:214-503-0315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0089529332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5740900001Medicare NSC