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General NPI Number Information
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NPI Number | 1952567950
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Entity Type | Organization
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Legal Business Name | ELITE TRANSPORTATION SERVICES, LLC
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 1509 MAURINE DR
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City | MEMPHIS
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State | TN
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Zip | 38116-7967
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Country | US
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Telephone | 901-378-2445
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 301208
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City | MEMPHIS
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State | TN
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Zip | 38130-1208
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Country | US
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Telephone | 901-378-2445
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LARRY HARRIS JR.
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Credential |
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Telephone | 901-378-2445
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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 | 108001952
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License Number State | TN
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