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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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