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General NPI Number Information
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NPI Number | 1174766786
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Entity Type | Organization
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Legal Business Name | THE ULTIMATE HEALTH SERVICES LLC
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Dates
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Enumeration Date | 04/13/2009
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 2555 MADISON AVE
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City | BALTIMORE
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State | MD
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Zip | 21217-4041
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Country | US
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Telephone | 301-326-7320
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Fax |
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Provider Business Mailing Address
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Address Line | 2555 MADISON AVE
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City | BALTIMORE
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State | MD
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Zip | 21217
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Country | US
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Telephone | 301-326-7320
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SIKIRAT IYABO DISU
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Credential |
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Telephone | 301-326-7320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | R2696
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License Number State | MD
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