Organization
ULTRA MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EZRIEL UNGAR (CONTROLLER)
(718) 796-7555
Entity
Organization
Contact information
Practice address
1331 BASELINE RD, UNIT 2, BULLHEAD CITY, AZ 86442-6719
(718) 796-7555
(516) 566-2395
Mailing address
1331 BASELINE RD, UNIT 2, BULLHEAD CITY, AZ 86442-6719
(718) 796-7555
(516) 566-2395
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
21026176
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
898874
—
AZ
Enumeration date
08/29/2014
Last updated
09/10/2014
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