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General NPI Number Information
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NPI Number | 1336478387
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Entity Type | Organization
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Legal Business Name | ULTRA CARE
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Dates
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Enumeration Date | 12/21/2009
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 802 E MARTINTOWN RD SUITE 157
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-5308
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Country | US
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Telephone | 803-278-0250
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Fax | 803-278-0251
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Provider Business Mailing Address
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Address Line | 802 E MARTINTOWN RD SUITE 157
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-5308
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Country | US
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Telephone | 803-278-0250
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Fax | 803-278-0251
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KATHLEEN CRIST
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Credential |
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Telephone | 803-278-0250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 036-R-0010
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License Number State | GA
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