Healthcare Provider Details

I. General information

NPI: 1427403526
Provider Name (Legal Business Name): ELITE EMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2016
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9463 HOLLY RD STE 104
GRAND BLANC MI
48439-2557
US

IV. Provider business mailing address

9463 HOLLY RD STE 104
GRAND BLANC MI
48439-2557
US

V. Phone/Fax

Practice location:
  • Phone: 810-599-9321
  • Fax:
Mailing address:
  • Phone: 810-599-9321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFF ROBSON
Title or Position: PRESIDET
Credential:
Phone: 810-599-9321