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General NPI Number Information
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NPI Number | 1316142953
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Entity Type | Organization
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Legal Business Name | ULTIMATECAREANDHOSPICELLC
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 110 TERRACE DR
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City | STAFFORD
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State | VA
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Zip | 22554-4864
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Country | US
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Telephone | 571-277-3838
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Fax |
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Provider Business Mailing Address
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Address Line | 110 TERRACE DR
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City | STAFFORD
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State | VA
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Zip | 22554-4864
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Country | US
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Telephone | 571-277-3838
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Fax | 703-441-1625
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Authorized Official
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Title or Position | PRESIDENTOPERATOR
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Name | MR. PHILIP OHENE ASIEDU
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Credential |
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Telephone | 571-277-3838
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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 | HCO07423
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License Number State | VA
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