Provider Demographics
NPI:1376085597
Name:ULTIMATE INTEGRATED PATIENT CARE PLLC
Entity Type:Organization
Organization Name:ULTIMATE INTEGRATED PATIENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:VALARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GROGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-718-5986
Mailing Address - Street 1:3225 N 75TH ST
Mailing Address - Street 2:SUITE 125
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6909
Mailing Address - Country:US
Mailing Address - Phone:480-718-5986
Mailing Address - Fax:
Practice Address - Street 1:3225 N 75TH ST
Practice Address - Street 2:SUITE 125
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6909
Practice Address - Country:US
Practice Address - Phone:480-718-5986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care HomeGroup - Multi-Specialty