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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