Provider Demographics
NPI:1164846127
Name:ULTIMATE HOME HEALTH CARE
Entity Type:Organization
Organization Name:ULTIMATE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KATSNELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-346-7180
Mailing Address - Street 1:111 BUCK ROAD OFFICE 300
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-2124
Mailing Address - Country:US
Mailing Address - Phone:215-346-7180
Mailing Address - Fax:215-599-8722
Practice Address - Street 1:111 BUCK ROAD OFFICW 300
Practice Address - Street 2:SUITE 2
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-2124
Practice Address - Country:US
Practice Address - Phone:215-346-7180
Practice Address - Fax:215-599-8722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05200501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA05200501OtherDEPARTMENT OF HEALTH CERTIFICATE OF LICENSURE