1083107346 NPI number — ULTIMATE HEALTHCARE SOLUTIONS INC.

Table of content: (NPI 1083107346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083107346 NPI number — ULTIMATE HEALTHCARE SOLUTIONS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ULTIMATE HEALTHCARE SOLUTIONS INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083107346
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3606 HIGHLAND AVE STE 108-109
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIGHLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92346-2603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-907-7995
Provider Business Mailing Address Fax Number:
909-864-1625

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3606 HIGHLAND AVE STE 108-109
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGHLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92346-2603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-907-7995
Provider Business Practice Location Address Fax Number:
909-864-1625
Provider Enumeration Date:
06/12/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
OKOREEH-KANGAH
Authorized Official First Name:
BEATRICE
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE-PRESIDENT
Authorized Official Telephone Number:
909-890-9660

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  A55122 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X , with the licence number: A55122 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)