Provider Demographics
NPI:1023413606
Name:HOLY MEDICARE INC
Entity type:Organization
Organization Name:HOLY MEDICARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FATIMO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ISHADIMU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-203-0303
Mailing Address - Street 1:3670 SCHOOL DR
Mailing Address - Street 2:APT/SUITE
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-4949
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3670 SCHOOL DR
Practice Address - Street 2:APT/SUITE
Practice Address - City:COUNTRY CLUB HILLS
Practice Address - State:IL
Practice Address - Zip Code:60478-4949
Practice Address - Country:US
Practice Address - Phone:708-203-0303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-25
Last Update Date:2014-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)