Provider Demographics
NPI:1073837894
Name:ELITE TRANSPORT, INC
Entity Type:Organization
Organization Name:ELITE TRANSPORT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISSAM
Authorized Official - Middle Name:SAMIR
Authorized Official - Last Name:HAMMOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-207-5943
Mailing Address - Street 1:27614 FORD RD.
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135
Mailing Address - Country:US
Mailing Address - Phone:313-207-5943
Mailing Address - Fax:734-524-0103
Practice Address - Street 1:27614 FORD RD.
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135
Practice Address - Country:US
Practice Address - Phone:313-207-5943
Practice Address - Fax:734-524-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)