Provider Demographics
NPI:1619154911
Name:MARGRET ULTRA HOME CARE INC
Entity Type:Organization
Organization Name:MARGRET ULTRA HOME CARE INC
Other - Org Name:MARGRET ULTRA HOME CARE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OGE
Authorized Official - Middle Name:MARGRET
Authorized Official - Last Name:UKATU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-815-8089
Mailing Address - Street 1:461 JEWETT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-2614
Mailing Address - Country:US
Mailing Address - Phone:718-815-8089
Mailing Address - Fax:718-815-8062
Practice Address - Street 1:461 JEWETT AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-2614
Practice Address - Country:US
Practice Address - Phone:718-815-8089
Practice Address - Fax:718-815-8062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0583L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0583L001OtherHOME CARE LICENSE #