Healthcare Provider Details

I. General information

NPI: 1578923587
Provider Name (Legal Business Name): ULTRAFLEX SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2016
Last Update Date: 03/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 MILL ST BLDG B
EAST BERLIN CT
06023-1159
US

IV. Provider business mailing address

1224 MILL ST BLDG B
EAST BERLIN CT
06023-1159
US

V. Phone/Fax

Practice location:
  • Phone: 609-459-1618
  • Fax: 610-901-1416
Mailing address:
  • Phone: 609-459-1618
  • Fax: 610-901-1416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK DEHARDE
Title or Position: PRESIDENT & CEO
Credential:
Phone: 610-901-1410