MEDICARE: ELITE MEDICAL TRANSPORT 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	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1659992162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE MEDICAL TRANSPORT LLC

Provider Business Mailing Address
First Line	:	6240 E SHELBY DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38141-7735
Country	:	US
Telephone Number	:	901-491-2911
Fax Number	:	901-422-5501

Provider Business Practice Location Address
First Line	:	6240 E SHELBY DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38141-7735
Country	:	US
Telephone Number	:	901-491-2911
Fax Number	:	901-422-5501

Authorized Official
Title or Position	:	CEO
Name	:	ELIZABETH GRAY
Credential	:	EMT P
Telephone Number	:	901-491-2911

Provider Enumeration Date	:	05/06/2020
Last Update Date	:	08/08/2025

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