Provider Demographics
NPI:1508016064
Name:MATTHEW ADELEKE
Entity Type:Organization
Organization Name:MATTHEW ADELEKE
Other - Org Name:ADEX MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-639-1907
Mailing Address - Street 1:209 N CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-1425
Mailing Address - Country:US
Mailing Address - Phone:310-639-1907
Mailing Address - Fax:310-999-6568
Practice Address - Street 1:209 N CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220
Practice Address - Country:US
Practice Address - Phone:310-639-1907
Practice Address - Fax:310-999-6568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6025160001Medicare NSC