Provider Demographics
NPI:1669332789
Name:ULTRA HEALTH MONETA
Entity type:Organization
Organization Name:ULTRA HEALTH MONETA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:BRIANA
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-385-1183
Mailing Address - Street 1:1039 MAYBERRY CROSSING DR STE A&B
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-6413
Mailing Address - Country:US
Mailing Address - Phone:540-210-8908
Mailing Address - Fax:
Practice Address - Street 1:1039 MAYBERRY CROSSING DR STE A&B
Practice Address - Street 2:
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121-6413
Practice Address - Country:US
Practice Address - Phone:540-210-8908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN CENTER URGENT CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health