MEDICARE: ULTIMATE MEDICAL EQUIPMENT 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
1	332BX2000X	Oxygen Equipment & Supplies (DME)	07667391W	AZ

General Provider Information

NPI Number	:	1386618460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTIMATE MEDICAL EQUIPMENT INC.

Provider Business Mailing Address
First Line	:	16602 N 23RD AVE
Second Line	:	SUITE # 111
City	:	PHOENIX
State	:	AZ
Zip	:	85023-3200
Country	:	US
Telephone Number	:	602-978-4100
Fax Number	:	602-978-4101

Provider Business Practice Location Address
First Line	:	16602 N 23RD AVE
Second Line	:	SUITE # 111
City	:	PHOENIX
State	:	AZ
Zip	:	85023-3200
Country	:	US
Telephone Number	:	602-978-4100
Fax Number	:	602-978-4101

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. THOMAS ESLICK
Credential	:
Telephone Number	:	602-978-4100

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	10/18/2007

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