Provider Demographics
NPI:1295484863
Name:ULTIMATE CARE PHARMACY
Entity type:Organization
Organization Name:ULTIMATE CARE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:HABASHY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:909-904-1572
Mailing Address - Street 1:2095 HIGHPOINTE DR APT 212
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-5957
Mailing Address - Country:US
Mailing Address - Phone:909-904-1572
Mailing Address - Fax:
Practice Address - Street 1:11741 STERLING AVE STE D2
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-4954
Practice Address - Country:US
Practice Address - Phone:909-904-1572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy