Organization
GROUND UP MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIWANDA DAVENPORT (CO-OWNER)
(773) 629-6700
Entity
Organization
Contact information
Practice address
10918 S WESTERN AVE STE 8, CHICAGO, IL 60643-3200
(773) 629-6700
(773) 881-3116
Mailing address
10918 S WESTERN AVE STE 8, CHICAGO, IL 60643-3200
(773) 629-6700
(773) 881-3116
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2042849
IL
Other
Enumeration date
07/05/2010
Last updated
07/05/2010
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