Healthcare Provider Details

I. General information

NPI: 1487565933
Provider Name (Legal Business Name): ULTIMATE SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2034 SPRING RUN CIR
FREDERICK MD
21702-6807
US

IV. Provider business mailing address

2034 SPRING RUN CIR
FREDERICK MD
21702-6807
US

V. Phone/Fax

Practice location:
  • Phone: 240-578-8510
  • Fax:
Mailing address:
  • Phone: 240-578-8510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GETRUD M JOHNSON
Title or Position: OWNER
Credential:
Phone: 240-578-8510