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Organization
ULTIMATE CARE MEDICAL SERVICES LLC
Active
Organization
ULTIMATE CARE MEDICAL SERVICES LLC
Active
Other names
Ultimate Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE URADU (PROGRAM DIRECTOR)
(606) 393-4632
Entity
Organization
Contact information
Practice address
3655 WINCHESTER AVE, ASHLAND, KY 41101-2065
(606) 393-4632
(888) 411-4131
Mailing address
3655 WINCHESTER AVE, ASHLAND, KY 41101-2065
(606) 393-4632
(888) 411-4131
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
810271
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
40541
KY
261QM2800X
Methadone Clinic
Primary
KY-10054-M
KY
3336C0002X
Clinic Pharmacy
10054
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1832977
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
7100090030
—
KY
Enumeration date
07/02/2009
Last updated
08/12/2021
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