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General NPI Number Information
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NPI Number | 1851942338
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Entity Type | Organization
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Legal Business Name | ULTRACARE LLC
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Dates
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Enumeration Date | 09/25/2019
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 4030 WAKE FOREST RD STE 349
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City | RALEIGH
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State | NC
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Zip | 27609-0010
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Country | US
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Telephone | 980-272-7898
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 455
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City | BOWLING GREEN
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State | SC
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Zip | 29703-0455
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Country | US
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Telephone | 980-272-7898
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHORTNEY BELLUCCI
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Credential |
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Telephone | 980-272-7898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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