Provider Demographics
NPI:1720032949
Name:ULTRAFLOW SYSTEMS, LLC
Entity Type:Organization
Organization Name:ULTRAFLOW SYSTEMS, LLC
Other - Org Name:SUSSEX VASCULAR LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:CMS,CVT
Authorized Official - Phone:302-629-2733
Mailing Address - Street 1:8866 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3655
Mailing Address - Country:US
Mailing Address - Phone:302-629-2733
Mailing Address - Fax:302-629-9639
Practice Address - Street 1:8866 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3655
Practice Address - Country:US
Practice Address - Phone:302-629-2733
Practice Address - Fax:302-629-9639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2006201984291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEFDUV03Medicare ID - Type UnspecifiedDIANGNOSTIC IMAGING LAB