Provider Demographics
NPI:1316252943
Name:DUPAUL MEDICAL SUPPLIES
Entity type:Organization
Organization Name:DUPAUL MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:OSUEGBU
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:770-882-8309
Mailing Address - Street 1:191 E BROAD ST STE 221
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30601-2848
Mailing Address - Country:US
Mailing Address - Phone:770-882-8309
Mailing Address - Fax:
Practice Address - Street 1:191 E BROAD ST
Practice Address - Street 2:SUITE 221
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-2847
Practice Address - Country:US
Practice Address - Phone:770-882-8309
Practice Address - Fax:770-406-2628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies