Provider Demographics
NPI:1174766786
Name:THE ULTIMATE HEALTH SERVICES LLC
Entity type:Organization
Organization Name:THE ULTIMATE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIKIRAT
Authorized Official - Middle Name:IYABO
Authorized Official - Last Name:DISU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-326-7320
Mailing Address - Street 1:2555 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217
Mailing Address - Country:US
Mailing Address - Phone:301-326-7320
Mailing Address - Fax:
Practice Address - Street 1:2555 MADISON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-4041
Practice Address - Country:US
Practice Address - Phone:301-326-7320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2696251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care