Holy Mary Incorporated

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

HOLY MARY INCORPORATED

Practice address

17711 Country Club LN
Country Club Hills, IL 60478-4920

Phone

(708) 845-5443

Fax

(708) 845-5443

NPI assigned

Mar 5, 2014

Organization subpart

No

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

Authorized official

Name

Omolara Billingsley

Title

President

Phone

(708) 845-5443

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393977600000",
    "number": "1104242890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17711 COUNTRY CLUB LN",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604784920",
            "telephone_number": "708-845-5443",
            "fax_number": "708-845-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17711 COUNTRY CLUB LN",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604784920",
            "telephone_number": "708-845-5443",
            "fax_number": "708-845-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY MARY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-05",
        "last_updated": "2014-03-05",
        "status": "A",
        "authorized_official_last_name": "BILLINGSLEY",
        "authorized_official_first_name": "OMOLARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-845-5443"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Country Club Hills, IL
• Providers in Country Club Hills, IL by specialty
• Non-emergency Medical Transport (VAN) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; 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.