Organization
ULTIMATE HOMECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLY RENEE GRIFFITH (V.P. OPERATIONS)
(866) 485-8463
Entity
Organization
Contact information
Practice address
3250 E 19TH ST, LONG BEACH, CA 90755-1244
(866) 485-8463
(888) 816-2999
Mailing address
3250 E 19TH ST, LONG BEACH, CA 90755-1244
(866) 485-8463
(888) 816-2999
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
200699
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ28477Z
BLUE SHIELD OF CA
CA
Enumeration date
05/18/2006
Last updated
08/22/2020
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