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General NPI Number Information
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NPI Number | 1306906839
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Entity Type | Organization
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Legal Business Name | ELITE MEDICAL TRANSPORT, LLC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 1700 S SILVER AVE
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City | DEMING
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State | NM
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Zip | 88030-5927
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Country | US
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Telephone | 575-544-4241
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Fax | 915-542-0706
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Provider Business Mailing Address
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Address Line | PO BOX 929
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City | SANTA TERESA
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State | NM
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Zip | 88008-0929
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Country | US
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Telephone | 915-542-1194
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | LEEANN PHILLIPS
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Credential |
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Telephone | 915-542-1194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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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 | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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