Healthcare Provider Details
I. General information
NPI: 1265224703
Provider Name (Legal Business Name): ELITE SCREENINGS & MORE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
102 OAK ST
STATESBORO GA
30458-4852
US
IV. Provider business mailing address
102 OAK ST
STATESBORO GA
30458-4852
US
V. Phone/Fax
- Phone: 844-503-3597
- Fax:
- Phone: 844-503-3597
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QC1800X |
| Taxonomy | Corporate Health Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QS1000X |
| Taxonomy | Student Health Clinic/Center |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARTISHA
HILL
Title or Position: FOUNDER
Credential: PHLEBOTOMIST
Phone: 844-503-3597