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General NPI Number Information
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NPI Number | 1760187207
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Entity Type | Organization
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Legal Business Name | ELITE TRANSPORTATION SOLUTIONS LLC
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 811 N 9TH AVE
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City | DURANT
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State | OK
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Zip | 74701-3727
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Country | US
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Telephone | 580-634-1432
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Fax |
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Provider Business Mailing Address
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Address Line | 811 N 9TH AVE
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City | DURANT
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State | OK
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Zip | 74701-3727
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Country | US
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Telephone | 580-634-1432
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | TIFFANY GOOSBY
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Credential |
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Telephone | 580-634-1432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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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 | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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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 | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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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 | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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