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General NPI Number Information
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NPI Number | 1326351859
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Entity Type | Organization
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Legal Business Name | ULTIMATE CAPCARE SERVICES LLC
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 08/19/2011
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Provider Practice Location Address
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Address Line | 624 S FAYETTEVILLE ST STE F1
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City | ASHEBORO
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State | NC
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Zip | 27203-6582
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Country | US
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Telephone | 336-327-2088
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Fax |
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Provider Business Mailing Address
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Address Line | 624 SOUTH FAYETTEVILL ST., SUITE F-1
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City | ASHEBORO
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State | NC
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Zip | 27203-0624
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | KESTER O OKORO
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Credential |
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Telephone | 336-327-2088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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