Provider Demographics
NPI:1437175841
Name:ULTRA HEALTH CARE INC
Entity Type:Organization
Organization Name:ULTRA HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:POMARE-BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-584-1718
Mailing Address - Street 1:3230 W COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3429
Mailing Address - Country:US
Mailing Address - Phone:800-584-1718
Mailing Address - Fax:954-735-9843
Practice Address - Street 1:3230 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3429
Practice Address - Country:US
Practice Address - Phone:800-584-1718
Practice Address - Fax:407-563-5495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992417251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108388Medicare Oscar/Certification