Provider Demographics
NPI:1134684111
Name:RISE UP MEDICAL SUPPLIES, INC.
Entity type:Organization
Organization Name:RISE UP MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-668-0335
Mailing Address - Street 1:10589 NW 53RD ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-8073
Mailing Address - Country:US
Mailing Address - Phone:954-949-9181
Mailing Address - Fax:
Practice Address - Street 1:10589 NW 53RD ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-8073
Practice Address - Country:US
Practice Address - Phone:954-530-5711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-05
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies