Healthcare Provider Details

I. General information

NPI: 1255209169
Provider Name (Legal Business Name): STAR ELITE ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 GREENE ST
ABBEVILLE LA
70510-6923
US

IV. Provider business mailing address

1117 GREENE ST
ABBEVILLE LA
70510-6923
US

V. Phone/Fax

Practice location:
  • Phone: 318-691-1024
  • Fax:
Mailing address:
  • Phone: 318-691-1024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: LEEANTHONY MILLER
Title or Position: OWNER
Credential:
Phone: 318-691-1024