Healthcare Provider Details

I. General information

NPI: 1902029515
Provider Name (Legal Business Name): ELITE HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1832 HARPER RD
BECKLEY WV
25801-3366
US

IV. Provider business mailing address

7 FAIRLAND CT
NITRO WV
25143-1118
US

V. Phone/Fax

Practice location:
  • Phone: 304-256-0070
  • Fax: 304-256-3703
Mailing address:
  • Phone: 304-776-5683
  • Fax: 304-776-5615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateWV

VIII. Authorized Official

Name: MR. MARK KENNETH SMITH
Title or Position: ADMINISTRATOR
Credential:
Phone: 304-776-5683