Provider Demographics
NPI:1225207673
Name:ULTRA HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:ULTRA HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DAMIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-669-5525
Mailing Address - Street 1:21913 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-2342
Mailing Address - Country:US
Mailing Address - Phone:727-669-5525
Mailing Address - Fax:727-712-1372
Practice Address - Street 1:21913 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-2342
Practice Address - Country:US
Practice Address - Phone:727-669-5525
Practice Address - Fax:727-712-1372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312497332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0713200001Medicare NSC