Provider Demographics
NPI:1003866500
Name:ULTIMATE MEDICAL SUPPLIES,INC
Entity Type:Organization
Organization Name:ULTIMATE MEDICAL SUPPLIES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EYO
Authorized Official - Middle Name:EYO
Authorized Official - Last Name:EPHRAIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-252-1685
Mailing Address - Street 1:2401 W PECAN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3419
Mailing Address - Country:US
Mailing Address - Phone:512-252-1685
Mailing Address - Fax:512-252-1694
Practice Address - Street 1:2401 W PECAN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3200
Practice Address - Country:US
Practice Address - Phone:512-252-1685
Practice Address - Fax:512-252-1694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0069039332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies