Provider Demographics
NPI:1093209272
Name:ELLEMSENTERPRISES, LLC
Entity Type:Organization
Organization Name:ELLEMSENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MONICA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:804-640-2101
Mailing Address - Street 1:PO BOX 3051
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-9701
Mailing Address - Country:US
Mailing Address - Phone:804-640-2101
Mailing Address - Fax:877-879-6336
Practice Address - Street 1:2202 HIGH BUSH CIR
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-2240
Practice Address - Country:US
Practice Address - Phone:804-640-2101
Practice Address - Fax:877-879-6336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle