MEDICARE: ELITE CARE NURSING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1154599801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE CARE NURSING SERVICES LLC

Provider Business Mailing Address
First Line	:	5005 S AMHERST HWY
Second Line	:
City	:	MADISON HEIGHTS
State	:	VA
Zip	:	24572-2490
Country	:	US
Telephone Number	:	434-846-1514
Fax Number	:

Provider Business Practice Location Address
First Line	:	5005 S AMHERST HWY
Second Line	:
City	:	MADISON HEIGHTS
State	:	VA
Zip	:	24572-2490
Country	:	US
Telephone Number	:	434-846-1514
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. BARBARA JEAN MILLER
Credential	:
Telephone Number	:	434-846-1514

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	02/15/2008

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