Provider Demographics
NPI:1841260585
Name:ULTIMATE CARE INC
Entity type:Organization
Organization Name:ULTIMATE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-566-8144
Mailing Address - Street 1:2 W BALTIMORE AVE
Mailing Address - Street 2:STE 305
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3740
Mailing Address - Country:US
Mailing Address - Phone:610-566-8144
Mailing Address - Fax:610-566-1617
Practice Address - Street 1:2 W BALTIMORE AVE
Practice Address - Street 2:STE 305
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3740
Practice Address - Country:US
Practice Address - Phone:610-566-8144
Practice Address - Fax:610-566-1617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01355330Medicaid
PA1010919330001Medicaid
NJ01355330Medicaid