Provider Demographics
NPI:1033460308
Name:ELITE CARE TRANSPORTATION, INC.
Entity Type:Organization
Organization Name:ELITE CARE TRANSPORTATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN-AVELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-856-6177
Mailing Address - Street 1:1639 NEWHAVEN POINT LN
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-6607
Mailing Address - Country:US
Mailing Address - Phone:561-856-6177
Mailing Address - Fax:
Practice Address - Street 1:1639 NEWHAVEN POINT LN
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-6607
Practice Address - Country:US
Practice Address - Phone:561-856-6177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLVH1180343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)