Healthcare Provider Details

I. General information

NPI: 1083118145
Provider Name (Legal Business Name): ELITE MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E HARMON AVE
LAS VEGAS NV
89109-4533
US

IV. Provider business mailing address

150 E HARMON AVE
LAS VEGAS NV
89109-4533
US

V. Phone/Fax

Practice location:
  • Phone: 702-445-5070
  • Fax: 281-503-7525
Mailing address:
  • Phone: 702-445-5070
  • Fax: 281-503-7525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: JAMES RESENDEZ
Title or Position: CEO
Credential:
Phone: 702-546-0911