| Ultimate Clinic LLC | |
|
1437 Sams Dr Ste 122 Chesapeake VA 23320-4587 | |
| (757) 549-3668 | |
| Not Available |
| Full Name | Ultimate Clinic LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1437 Sams Dr Ste 122, Chesapeake, Virginia |
| Authorized Official Name and Position | Ryan Sadinski (PARTENER) |
| Authorized Official Contact | 7575376050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ultimate Clinic LLC 1437 Sams Dr Ste 122 Chesapeake VA 23320-4587 Ph: (757) 549-3668 | Ultimate Clinic LLC 1437 Sams Dr Ste 122 Chesapeake VA 23320-4587 Ph: (757) 549-3668 |
| NPI Number | 1023640349 |
|---|---|
| Provider Enumeration Date | 02/05/2020 |
| Last Update Date | 03/09/2020 |
| Certification Date | 03/09/2020 |
| Medicare PECOS PAC ID | 4587092762 |
|---|---|
| Medicare Enrollment ID | O20200323000485 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023640349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| 261QP3300X | Clinic/center - Pain | () | Secondary |
| Provider Name | Kevin Chou |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609859834 PECOS PAC ID: 4880738509 Enrollment ID: I20100218000883 |
| Provider Name | Ryan E Sadinski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003307455 PECOS PAC ID: 4789938812 Enrollment ID: I20181108001438 |
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