Provider Demographics
NPI:1821276056
Name:IMMACULATE EMS, INC
Entity Type:Organization
Organization Name:IMMACULATE EMS, INC
Other - Org Name:IMMACULATE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ANANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-419-1199
Mailing Address - Street 1:PO BOX 570185
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77257-0185
Mailing Address - Country:US
Mailing Address - Phone:832-419-1199
Mailing Address - Fax:
Practice Address - Street 1:9001 AIRPORT BLVD STE 703
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77061-3447
Practice Address - Country:US
Practice Address - Phone:832-419-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies