MEDICARE: ELITE MEDICAL TRANSPORTATION 2 LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance

General Provider Information

NPI Number	:	1114551488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE MEDICAL TRANSPORTATION 2 LLC

Provider Business Mailing Address
First Line	:	425 W SCHROCK RD STE B1
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-8718
Country	:	US
Telephone Number	:	614-288-7982
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 W SCHROCK RD STE B1
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-8718
Country	:	US
Telephone Number	:	614-288-7982
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BRANDON SWAIN
Credential	:
Telephone Number	:	614-288-7982

Provider Enumeration Date	:	02/26/2020
Last Update Date	:	02/26/2020

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Directions to “ELITE MEDICAL TRANSPORTATION 2 LLC ” Practice Location

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