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General NPI Number Information
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NPI Number | 1457781155
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Entity Type | Organization
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Legal Business Name | ELITE CARE INC
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Dates
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Enumeration Date | 11/15/2013
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Last Update Date | 11/15/2013
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Provider Practice Location Address
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Address Line | 3836 ABBY LYNN DR
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City | GREENVILLE
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State | NC
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Zip | 27858-7315
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Country | US
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Telephone | 252-814-6957
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Fax |
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Provider Business Mailing Address
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Address Line | 410 N MAIN ST
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City | TARBORO
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State | NC
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Zip | 27886-4311
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Country | US
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Telephone | 252-824-3007
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEMETRICE YVONNE WILSON
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Credential |
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Telephone | 252-792-7812
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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 |
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License Number State |
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