Provider Demographics
NPI:1386304889
Name:TRI CITIES ULTIMATE CARE
Entity type:Organization
Organization Name:TRI CITIES ULTIMATE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-307-3848
Mailing Address - Street 1:14408 W 344 PR NW
Mailing Address - Street 2:
Mailing Address - City:BENTON CITY
Mailing Address - State:WA
Mailing Address - Zip Code:99320-7780
Mailing Address - Country:US
Mailing Address - Phone:509-836-9652
Mailing Address - Fax:
Practice Address - Street 1:14408 W 344 PR NW
Practice Address - Street 2:
Practice Address - City:BENTON CITY
Practice Address - State:WA
Practice Address - Zip Code:99320-7780
Practice Address - Country:US
Practice Address - Phone:509-836-9652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health