Healthcare Provider Details

I. General information

NPI: 1720921950
Provider Name (Legal Business Name): ELITE XPRESS LOGISTICS AND SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 SPYGLASS CIR
PAINESVILLE OH
44077
US

IV. Provider business mailing address

1919 SPYGLASS CIR
PAINESVILLE OH
44077
US

V. Phone/Fax

Practice location:
  • Phone: 216-577-1970
  • Fax:
Mailing address:
  • Phone: 216-577-9017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: TELINA GOCHER
Title or Position: GENERAL MANAGER
Credential: LPN
Phone: 216-577-9017