Provider Demographics
NPI:1740630177
Name:LEADWAY MEDICAL SUPPLIES
Entity type:Organization
Organization Name:LEADWAY MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OYEJIDE
Authorized Official - Middle Name:JULIUS
Authorized Official - Last Name:ADEWOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-912-4812
Mailing Address - Street 1:9370 W SAM HOUSTON PKWY S # E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-5224
Mailing Address - Country:US
Mailing Address - Phone:281-912-4812
Mailing Address - Fax:
Practice Address - Street 1:9370 W SAM HOUSTON PKWY S # E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-5224
Practice Address - Country:US
Practice Address - Phone:281-912-4812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies