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General NPI Number Information
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NPI Number | 1457891145
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Entity Type | Organization
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Legal Business Name | ULTRA HEALTH LLC
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Dates
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Enumeration Date | 03/01/2017
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 1039 MAYBERRY CROSSING DR STE A&B
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City | MONETA
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State | VA
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Zip | 24121-6413
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Country | US
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Telephone | 540-546-3744
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 489
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City | POUNDING MILL
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State | VA
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Zip | 24637-0489
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Country | US
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Telephone | 276-385-1183
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Fax | 276-258-6492
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Authorized Official
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Title or Position | OWNER
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Name | JEFFERY H TAYLOR
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Credential |
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Telephone | 276-971-0783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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