Healthcare Provider Details

I. General information

NPI: 1457232563
Provider Name (Legal Business Name): ELVIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12227 TAYLORS WAY
PICKERINGTON OH
43147-9964
US

IV. Provider business mailing address

12227 TAYLORS WAY
PICKERINGTON OH
43147-9964
US

V. Phone/Fax

Practice location:
  • Phone: 380-254-7106
  • Fax:
Mailing address:
  • Phone: 380-254-7106
  • 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: ELVIS JOMIA
Title or Position: MR
Credential:
Phone: 380-254-7106