1285668590 NPI number — ULTIMATE MOBILITY, INC.

Table of content: (NPI 1285668590)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285668590 NPI number — ULTIMATE MOBILITY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ULTIMATE MOBILITY, 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:
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:
1285668590
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1158 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WORCESTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01603-2011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-363-1227
Provider Business Mailing Address Fax Number:
508-363-1228

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1158 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WORCESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01603-2011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-363-1227
Provider Business Practice Location Address Fax Number:
508-363-1228
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCCULLOUGH
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
508-363-1227

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1539086 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 98862301 . This is a "NETWORK HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: EVERCARE . This is a "8280484" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0017588 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 390654 . This is a "BCBSMA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 685813 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 42615 . This is a "FALLON COMMUNITY HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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