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NPI Code Detail

MEDICARE: ULTIMATE HEALTH INC

MEDICARE: ULTIMATE HEALTH INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1194147058
Entity Type Code : Organization
Provider Name (Legal Business Name) : ULTIMATE HEALTH INC
Provider Business Mailing Address
First Line : 1394 JACKSON ST
Second Line : SUITE 105
City : SAINT PAUL
State : MN
Zip : 55117-4629
Country : US
Telephone Number : 612-501-0484
Fax Number :
Provider Business Practice Location Address
First Line : 1394 JACKSON ST
Second Line : SUITE 105
City : SAINT PAUL
State : MN
Zip : 55117-4629
Country : US
Telephone Number : 612-501-0484
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. GARAT IBRAHIM
Credential :
Telephone Number : 612-501-0484
Provider Enumeration Date : 01/13/2014
Last Update Date : 01/13/2014

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Directions to “ULTIMATE HEALTH INC ” Practice Location

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