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General NPI Number Information
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NPI Number | 1033460308
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Entity Type | Organization
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Legal Business Name | ELITE CARE TRANSPORTATION, INC.
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Dates
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Enumeration Date | 09/27/2012
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Last Update Date | 09/27/2012
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Provider Practice Location Address
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Address Line | 1639 NEWHAVEN POINT LN
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-6607
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Country | US
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Telephone | 561-856-6177
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Fax |
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Provider Business Mailing Address
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Address Line | 1639 NEWHAVEN POINT LN
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-6607
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Country | US
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Telephone | 561-856-6177
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHARIDA KHAN-AVELLA
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Credential |
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Telephone | 561-856-6177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | VH1180
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License Number State | FL
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