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General NPI Number Information
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NPI Number | 1063827996
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Entity Type | Organization
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Legal Business Name | ULTICARE HOME HEALTH AGENCY INC.
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 06/30/2014
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Provider Practice Location Address
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Address Line | 9215 GLEN MEADOW LN
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City | BRISTOW
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State | VA
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Zip | 20136-3109
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Country | US
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Telephone | 703-753-5815
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Fax |
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Provider Business Mailing Address
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Address Line | 9215 GLEN MEADOW LN
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City | BRISTOW
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State | VA
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Zip | 20136-3109
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Country | US
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Telephone | 703-753-5815
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | ROBSON NYEREYEMHUKA
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Credential |
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Telephone | 571-332-5066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | VA
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