Provider Demographics
NPI:1073653499
Name:ULTIMATE DME
Entity Type:Organization
Organization Name:ULTIMATE DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-889-5080
Mailing Address - Street 1:31344 VIA COLINAS
Mailing Address - Street 2:109
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3912
Mailing Address - Country:US
Mailing Address - Phone:818-889-5080
Mailing Address - Fax:818-889-2543
Practice Address - Street 1:31344 VIA COLINAS
Practice Address - Street 2:109
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3912
Practice Address - Country:US
Practice Address - Phone:818-889-5080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies