Provider Demographics
NPI:1427401942
Name:GEORGIA ELITE AMBULANCE SERVICE INC.
Entity Type:Organization
Organization Name:GEORGIA ELITE AMBULANCE SERVICE INC.
Other - Org Name:ELITE AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKBAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JIWANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-290-8646
Mailing Address - Street 1:2445 HILTON DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-6275
Mailing Address - Country:US
Mailing Address - Phone:470-290-8646
Mailing Address - Fax:
Practice Address - Street 1:2445 HILTON DR
Practice Address - Street 2:SUITE 104
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-6275
Practice Address - Country:US
Practice Address - Phone:470-290-8646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMB20160103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport