Healthcare Provider Details

I. General information

NPI: 1073764379
Provider Name (Legal Business Name): ULTIMATE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5897 STATE ROUTE 7
PROCTORVILLE OH
45669-0000
US

IV. Provider business mailing address

5170 US ROUTE 60 E
HUNTINGTON WV
25705-2065
US

V. Phone/Fax

Practice location:
  • Phone: 740-886-9911
  • Fax: 740-886-9922
Mailing address:
  • Phone: 304-528-4600
  • Fax: 304-697-0856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARK A MORGAN
Title or Position: CEO
Credential:
Phone: 304-528-4600