Provider Demographics
NPI:1346577897
Name:ELITE MEDICAL LLC
Entity Type:Organization
Organization Name:ELITE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MISTI
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-238-6090
Mailing Address - Street 1:12980 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-3426
Mailing Address - Country:US
Mailing Address - Phone:440-238-6090
Mailing Address - Fax:440-238-6091
Practice Address - Street 1:12980 PEARL RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-3426
Practice Address - Country:US
Practice Address - Phone:440-238-6090
Practice Address - Fax:440-238-6091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1886604332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6402190001Medicare NSC