Organization Active NPI

Okereke Moses Madubuike

  • Durable Medical Equipment & Medical Supplies
  • Grand Prairie, TX
National Provider Identifier
1073619342
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0079619 Issued in TX
Legal business name
OKEREKE MOSES MADUBUIKE
Practice address
2307 Oak Lane #205
Grand Prairie, TX 75051
Phone
(972) 237-9066
Fax
(972) 237-9056
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Okereke Moses Madubuike
Title
President
Phone
(972) 237-9066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0079619 TX Primary

Addresses

Primary practice location

2307 Oak Lane #205
Grand Prairie, TX 75051

Mailing address

2307 Oak Lane
Grand Prairie, TX 75051
Phone (972) 237-9066

Other identifiers 2

IdentifierTypeStateIssuer
178550301MedicaidTX
178550302MedicaidTX

Other names 1

  • Access Medical Supply Doing business as

National Provider Directory

National Provider Directory

Locations

2307 Oak Ln
Grand Prairie, TX 75051
Phone (214) 666-6063

2307 Oak Ln
Ste 205
Grand Prairie, TX 75051
Phone (972) 237-9066

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1073619342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 OAK LANE",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75051",
            "telephone_number": "972-237-9066",
            "fax_number": "972-237-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 OAK LANE #205",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75051",
            "telephone_number": "972-237-9066",
            "fax_number": "972-237-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKEREKE MOSES MADUBUIKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "MADUBUIKE",
        "authorized_official_first_name": "OKEREKE",
        "authorized_official_middle_name": "MOSES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-237-9066",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0079619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178550301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178550302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Access Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.