Provider Demographics
NPI:1073764379
Name:ULTIMATE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:ULTIMATE HEALTH SERVICES, INC.
Other - Org Name:HUNTINGTON INTERNAL MEDICINE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-528-4600
Mailing Address - Street 1:5170 US ROUTE 60 E
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2065
Mailing Address - Country:US
Mailing Address - Phone:304-528-4600
Mailing Address - Fax:304-697-0856
Practice Address - Street 1:5897 STATE ROUTE 7
Practice Address - Street 2:
Practice Address - City:PROCTORVILLE
Practice Address - State:OH
Practice Address - Zip Code:45669-0000
Practice Address - Country:US
Practice Address - Phone:740-886-9911
Practice Address - Fax:740-886-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9331661Medicare PIN
OHH225340Medicare PIN