Provider Demographics
NPI:1235364662
Name:ELITE MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:ELITE MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-484-8454
Mailing Address - Street 1:19 PHELPS AVE
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-2819
Mailing Address - Country:US
Mailing Address - Phone:201-484-8454
Mailing Address - Fax:201-484-8485
Practice Address - Street 1:19 PHELPS AVE
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-2819
Practice Address - Country:US
Practice Address - Phone:201-484-8454
Practice Address - Fax:201-484-8485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies