NPIMap

Organization Active NPI

Immaculate Activities Corporation

  • Durable Medical Equipment & Medical Supplies
  • Detroit, MI
National Provider Identifier
1407136245
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
IMMACULATE ACTIVITIES CORPORATION
Practice address
6904 Faust Ave
Detroit, MI 48228-3495
Phone
(313) 982-7381
NPI assigned
Aug 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Authorized official

Name
Mr. Samuel Ola OkunawoNPI 1477835833
Title
Owner
Phone
(313) 982-7381

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

6904 Faust Ave
Detroit, MI 48228-3495

Mailing address

6904 Faust Ave
Detroit, MI 48228-3495

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314230400000",
    "number": "1407136245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6904 FAUST AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6904 FAUST AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283495",
            "telephone_number": "313-982-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMACULATE ACTIVITIES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2011-08-25",
        "status": "A",
        "authorized_official_last_name": "OKUNAWO",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "OLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-982-7381",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.