Healthcare Provider Details

I. General information

NPI: 1154240760
Provider Name (Legal Business Name): ELEVATE DME SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6416 REA RD SUITE B7 #78172
CHARLOTTE NC
28277-9761
US

IV. Provider business mailing address

6416 REA RD SUITE B7 #78172
CHARLOTTE NC
28277-9761
US

V. Phone/Fax

Practice location:
  • Phone: 704-920-0109
  • Fax:
Mailing address:
  • Phone: 704-920-0109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KINYEL LACHEE DEPASS
Title or Position: CEO
Credential:
Phone: 704-920-0109