Provider Demographics
NPI:1649467275
Name:ULTIMATE TRANSPORTATION, INC
Entity type:Organization
Organization Name:ULTIMATE TRANSPORTATION, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADOLF
Authorized Official - Middle Name:N
Authorized Official - Last Name:NGUNDAM
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:703-988-0279
Mailing Address - Street 1:6000 STEVENSON AVE STE A
Mailing Address - Street 2:6000 STEVENSON AVE STE A
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-3526
Mailing Address - Country:US
Mailing Address - Phone:703-988-0279
Mailing Address - Fax:703-461-3552
Practice Address - Street 1:6000 STEVENSON AVE STE A
Practice Address - Street 2:6000 STEVENSON AVE. SUITE A
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3526
Practice Address - Country:US
Practice Address - Phone:703-988-0279
Practice Address - Fax:703-988-0279
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:N/A
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0117004815341600000X
DC341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance