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General NPI Number Information
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NPI Number | 1295079465
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Entity Type | Organization
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Legal Business Name | ELITE MEDICAL & MOBILITY, LLC
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Dates
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Enumeration Date | 11/12/2012
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 7111 ELM ST
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City | FRISCO
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State | TX
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Zip | 75034-4234
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Country | US
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Telephone | 214-872-1880
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Fax | 214-380-9393
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Provider Business Mailing Address
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Address Line | 11812 COUNTY ROAD 1104
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City | CELINA
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State | TX
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Zip | 75009-2776
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Country | US
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Telephone | 214-697-4851
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAMELA ETZEL
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Credential |
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Telephone | 214-872-1880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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