Provider Demographics
NPI:1922240654
Name:UPTOWN MEDICAL SUPPLY & EQUIPMENT, INC.
Entity Type:Organization
Organization Name:UPTOWN MEDICAL SUPPLY & EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-534-1945
Mailing Address - Street 1:3129 INTERSTATE 30
Mailing Address - Street 2:SUITE A
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2701
Mailing Address - Country:US
Mailing Address - Phone:214-534-1945
Mailing Address - Fax:
Practice Address - Street 1:3129 INTERSTATE 30
Practice Address - Street 2:SUITE A
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2701
Practice Address - Country:US
Practice Address - Phone:214-534-1945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0089506332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies