MEDICARE: ULTIMATE HOME HEALTH CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant	HC3077	NC
2	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447305651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTIMATE HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	PO BOX 30345
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27833-0345
Country	:	US
Telephone Number	:	252-353-8880
Fax Number	:	252-353-5206

Provider Business Practice Location Address
First Line	:	3011 S MEMORIAL DR STE 6
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-6238
Country	:	US
Telephone Number	:	252-353-8880
Fax Number	:	252-353-5206

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. GLENDA JEAN BRYANT
Credential	:
Telephone Number	:	252-353-8880

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	05/04/2023

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Directions to “ULTIMATE HOME HEALTH CARE ” Practice Location

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